Coronary Heart Disease

Coronary heart disease (CHD) is when your arteries get narrower due to a build-up of fatty deposits inside them. This restricts the flow of blood and can lead to chest pain, called angina, or a heart attack.

Your heart needs to work harder in pregnancy so, if you've got heart disease, it's important to get the right care and support.

You can develop heart problems for the first time during pregnancy. Or, you might not know you have a heart problem and it's discovered during your pregnancy or after you give birth.

You have a higher chance of developing CHD if you:

smoke
are overweight
have a family history of early CHD - if your father or brother was diagnosed with CHD before the age of 55, or your mother or sister was diagnosed before the age of 65
have diabetes
have high blood pressure
have high cholesterol
do not do enough physical activity

The more of these things you have, the more likely it is you'll develop heart disease.

Ask for an urgent GP appointment or get help from NHS 111 if:

You're pregnant and have:

chest pain that comes and goes
breathlessness that comes and goes

These could be signs of a heart or lung problem and need to be checked.

You can call 111 or get help from NHS 111 online.

Call 999 if you have:

sudden chest pain that:

spreads to your arms, back, neck, jaw or tummy
makes your chest feel tight or heavy
also started with shortness of breath, sweating and feeling or being sick

This could be a sign of a heart attack.

Planning for pregnancy

If you have heart disease, the best way to ensure a healthy pregnancy is to visit your GP or heart specialist (cardiologist) before you start trying for a baby. This is called pre-pregnancy counselling or pre-conception counselling.

Your specialist can discuss with you:

how your heart condition might affect your pregnancy
how pregnancy might affect your heart condition
your medicine - this may include a plan for stopping your medicine or switching to a different one to minimise the risks to you and your baby

If it is not possible to stop taking certain medicines, your doctor can discuss the chances of any problems associated with this treatment during your pregnancy.

Do not stop taking any medicines without consulting your doctor or cardiologist first.

Aspirin

If you're taking low-dose aspirin for your condition, it's safe to continue during pregnancy.

Stent

If you have had a stent (a tiny tube used to widen a blood vessel) inserted to stop your arteries from becoming narrowed or blocked, you'll need to discuss with your cardiologist:

how pregnancy may affect the stent
the best way of managing the stent in pregnancy so it works properly

Getting ready for pregnancy

You can prepare for pregnancy by:

losing weight, if you're overweight
not smoking
exercising regularly

Find out more about coronary heart disease.

What problems can CHD cause in pregnancy?

Cardiac disease and blood clots are the leading causes of death in pregnancy and the first few weeks after the birth.

Some of the medicines you may be taking for CHD or related conditions, such as diabetes or high blood pressure, can affect your baby. Talk to your care team about the medicines you're taking and the risk and benefits to you and your baby.

Your care in pregnancy

During your pregnancy, you should be under the care of a consultant obstetrician and a cardiologist in a hospital maternity unit.

You can expect to have more frequent antenatal check-ups, particularly if your CHD is related to other conditions, such as diabetes or high blood pressure.

Make sure you attend all your appointments or reschedule them if you have to cancel.

While you're pregnant you should:

eat a balanced diet - find out more about a healthy diet in pregnancy and foods to avoid in pregnancy
talk to a midwife about weight changes in pregnancy and how to stay in a healthy range
stay physically active - but speak to your midwife or GP before taking up any new exercise
stop smoking

Labour and birth

Discuss your options for where you can give birth with your healthcare team. This might include a heart specialist with experience in treating heart disease during pregnancy.

You may be advised to give birth in hospital.

Find out more about labour and birth.

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