Heart Warming

When I was 4 months pregnant with Helen, Brian & I began the house-hunting in earnest.  There was a tight market in our area, and we learned quickly after some trial and error offers that we had to leap on a house as soon as it was available and cross our fingers.

At the time, we were living in an apartment on the 3rd floor.  Day by day, I was getting more and more winded going up the stairs to our place.  Sometimes I would be carrying groceries, and I'd get to the top landing with my heart racing a mile a minute.  Other times I wouldn't be carrying anything, and I'd still have to rest for a minute when I got inside.  

Now I know I'm not in shape, but it felt a little ridiculous to be unable to handle that little walk upstairs.  And I could just picture how it would go carting a baby, too.  Which suddenly was a very good reason to move out of that apartment.

My lease wasn't up until a few months after my due date.  I had a chat with the manager, and they would be able to let me out of my lease early with a note from the doctor.  So at my next visit to the OB, I explained my heart issues and 3rd floor issues and wondered aloud if she could possibly write me a letter to expedite the whole lease-breaking thing.

Instead, she sent me to a cardiologist.

Apparently I'd focused a little too much on the heart problem and not enough on the "I need a letter" problem.  But I was far enough along in my pregnancy to realize things might not be normal.   Or, at the very least, it was worth mentioning to a doctor.  Typically in the 2nd trimester, you notice a faster heart rate because your blood volume increases by 30%.  The heart has to work that much harder, and so it's not uncommon to feel exhausted by a little bit of effort.   But just to make sure, she recommended the appointment with the specialist.

So I went.  And walking into the waiting room, I thought it might be a huge exercise in futility to spend my hard-earned co-payment in that place.  I was half the age of everyone in that waiting room, and noticeably pregnant.  I got more than a few long glances in my direction, and I'm sure even the nurses were wondering why a young pregnant person was going to see a heart doctor.

The doctor was extremely thorough.  I got an EKG and an echocardiogram, and both of them came back normal.  He also listened to my heart but didn't detect anything unusual.  He got a complete history and explained everything to me about what they would do next.

I went home that day with a monitor that I had to wear for a month, and whenever I felt that unusually high pulse racing, I had to push a button to record it.  Any strange or fluttering episodes were duly noted as well.  My chief complaint at this point was, dang, I have another month to wait to get a letter.  At this point, I was feeling pretty stupid for having pursued this route.

At the end of the month, I was back at the doctor's office and they reported on the findings of all my careful monitoring - nothing unusual.  In fact, I believe they used the words "stone-cold normal."  Um.  Crap.  So they did an ultrasound of my heart, and that's when the doctor finally hit paydirt.

It turns out I have a leaky valve in my left ventricle, a condition called mitral valve prolapse.  Normally as the heart pumps blood through the 4 chambers, the valves close off behind the blood, keeping everything where it should be.  But one of mine doesn't shut all the way, leaving some blood to flow back into the chamber it came from, and this can cause a variety of problems.  Depending on how bad the leaking is, I have heart racing, chest pain, shortness of breath and a risk of a few other things.  The doctor told me that the pregnancy wouldn't pose a problem, in spite of the increased blood flow, but during the delivery I would need IV antibiotics to make sure I didn't get an infection in my heart.

I asked him if this would be a problem for walking up & down 3 flights of stairs, as I continued in the pregnancy.  He said I could look for another place to live, but that I should be fine and able to lead a very normal life.  Decades from now, I might need medicine or surgery, but for now I was fine.

Not the answer I was looking for, obviously.

Back at the OB's office, I learned that the two doctors had chatted, and my OB was willing to write the letter based on his findings.  A month later, we had our house and a move-in date, and everything seemed to be smooth sailing until Helen showed up 10 days before the closing.  The rest is history.

That is, until pregnancy #2, when I was instructed by my OB to make sure everything was in order with the cardiologist.  At that appointment, I learned that the leaking has gotten worse, to the point that once I'm through with breast-feeding, I will need to start medication.  I've also got an enlarged left ventricle from the pressure build-up of the blood flowing back into that chamber.  For now it's just above the normal limits, and it's possibly due to the pregnancy.  But my doctor can hear the abnormal heart rhythm on his stethoscope now.  

This last visit to the cardiologist, I learned that heart disease is the #1 cause of death for women.  That's startling.  Both my grandmother and great-grandmother died of sudden heart attacks.  There is a strong family history of mitral valve prolapse as well.  I didn't know about that until I was diagnosed and shared the news with my mother.   So there's a small cause to be concerned and watch for developments and do whatever I can to fix this.

Honestly, I wouldn't even know about this condition if I didn't have an OB looking out for her malpractice insurance and a cardiologist who methodical tested me every single way possible.  All I wanted was to get out of my apartment!  

It makes me feel a little less ridiculous.  And I'd encourage you all to pay attention to your own little heart racing, chest pain, shortness of breath issues that could mean the difference between ridiculous and medication.  

To read more about mitral valve prolapse, click here.