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    Women and Heart Disease: Pregnancy Induced Heart Failure

    Courtney Hoppenjans Heart Patient, Deaconess Health System 02/09/2018

    On January 23 2014, I walked into Dr. Elizabeth Ott’s office for a routine prenatal appointment. Taking deep breaths and settling down into a chair, I remember thinking that I was winded and that the next 7 weeks would be interesting. Dr. Ott’s nurse walked out to call another patient and made eye contact with me; she asked if I was doing ok. I shook my head yes, took another deep breath, and waited my turn. Within a moment, she came out and called me, and brought me to her office. She looked me in the eyes and asked me to tell her what I was feeling. When I tried to say “oh I’m fine,” she asked me again, and I told her I felt like I couldn’t take a breath and was really tired. She walked me to the next room over, and within a minute her and Dr. Ott were standing in front of me. Dr. Ott checked my pulse again, and asked me what I was feeling and that my heart rate was high in the 140-150s and that I needed to tell her everything I was feeling. I talk about how I felt like I couldn’t breathe when I laid down, my heart was pounding sometimes, and that I couldn’t catch my breath sometimes. Dr. Ott and her nurse spoke briefly and told me I was going to The Heart Hospital immediately. I remember telling them that I would drive over, and that’s when Dr. Ott looked me in the eyes and said “this is serious.” My stomach dropped, and that’s the week my life changed…

    I was diagnosed the following day with Peripartum Cardiomyopathy or pregnancy induced heart failure at the age of 25. I was and still am a healthy, non –smoking, runs often kind of woman that was determined to have a healthy pregnancy.  I was so confused about what was happening and why. Dr. Frank Pamelia sat close to my bed at The Heart Hospital and explained how my heart was pumping poorly with an ejection fraction (or EF) of 25% and that normal is between 55-75%. My heart was weakened, enlarged, and I would need to start heart medications immediately. I asked him what caused this, and that’s when I learned that there is not a known cause.  I was upset and terrified, and he gave compassionate care and assured me he would be there for me. Dr. Pamelia gave me confidence that me and my baby would survive this complication.

    The Heart Hospital and Women’s Hospital came together for a meeting to decide my plan of care, and the plan was to have a C-Section at The Heart Hospital with the OB staff present.  So, at 33 weeks and 4 days, August James was born and rushed off to the NICU where he received wonderful, attentive, and loving care for the next 16 days. Once he was born, my heart rate dropped and I responded well to the medications. Two weeks later, I was back to 45% EF and three months later I was back to a normal EF.

    Peripartum Cardiomyopathy affects between 1000-1300 women a year, and sadly women have lost their lives to this complication. PPCM arises during the last trimester and up to 6 months after birth. There is a list of risk factors however, I did not meet any of the standard criteria. This is a condition not listed in “What to Expect When Expecting,” but the author, Heidi Murkoff, has stated that this will be in the newest edition. So until then, I’ll pass on the self-test checklist that was created by Dr. James Fett to help pregnant women and doctors screen for PPCM symptoms.

    I want to thank My OB provider, Dr. Ott, and OB nurse from Women’s Health Care P.C. for not letting me dismiss my symptoms and for being attentive providers who recognized what was normal vs abnormal. I loved my experience with Deaconess and have referred my friends and family to the hospital for their care. I want to thank Dr. Frank Pamelia and Dr. Elizabeth Ott for being there for a scared 25-year-old, first time mother and reassuring me that they all would be watching and caring for me. I am so thankful for an interdisciplinary team that worked hard to make sure that my little man and me made it through this rare pregnancy complication. Today he is a thriving 4 year old, and I have recovered completely and went on to have another child May 2, 2017 in Dallas, TX. I truly hope my story will help women remember to listen to their bodies all the time, but especially during pregnancy.

    Photography courtesy of Sarah Gillogly Studios.

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