Question on symptoms for Dr. Fett

[Kimberly Sidden]

Dr. Fett,

I am currently 12 1/2 weeks pregnant with my post PPCM baby. I was fully recovered with an EF of 65% prior to this pregnancy, (which was a surprise :) )I have been taking my blood pressure on a regular basis and it remains around 105/68 - 110/72. It seems like I am having a little difficulty breathing currently. Not really shortness of breath, I'm just noticing that it is more difficult. I've also been having some strong headaches, which are probably hormonal and have noticed my heart beats more than I ever did in the past. I have gained around 8 lbs so far and would be considered of normal weight prior to this pregnancy, 5'10" 152 lbs. I am much more cognizant of every little detail this time. My questions are: 1.) does high blood pressure always accompany PPCM? 2.) does swelling always accompany PPCM? 3.) Should I insist on an echo in my 2nd trimester? I had an echo in August which was normal and my cardiologist recommended another in February, I am due May 10th. 4.) Are there any other symptoms I should be watching for?

Thank you so much for your help!

Kimberly

[SarahsMom]

Kimberly,

Are you on any medication (Toprol)?????? I take 50mg's twice a day (I'm 15 weeks pregnant). I notice that after I take my medication, I have some difficulty breathing and it goes away after an hour or so. What's your heart rate? Mine is usually around 83-88 bpm and at my ob/gyn visit at 12 weeks my ob/gyn said that my heartrate was at 105 and that he didn't like it that high. He said to call my cardiologist and tell him that you're going up on your medication to 100mg's per day. He said that he didn't want my heart working that hard. My heart rate is back to 83-88 bpm.

I know it's scary and it's very good that your in tune with your body!

Kari

[Kimberly Sidden]

Hi! Kari,

My heart rate runs between 72-81 and I am not currently on any medications. I have an appointment with my perinatologist tomorow,so I can run some of these things by her as well. My cardiologist does not plan to see me unless there are any symptoms. She saidthat I'll have an echo in February, but nothing until then. I'm probably being paranoid. Last time I was blissfully unaware, (in spite of 40 lbs of fluid and high blood pressure), I thought everything I was experiencing was "just pregnancy" and I enjoyed every minute. This time I'm on guard and not able to enjoy it as much.

Kimberly

[SarahsMom]

Kimberly,

Personally, I would demand that your cardiologist give you an echo every trimester. I would also recommend seeing your cardiologist once a month. You can also go to your GP and get a BNP blood test....I would definitely get one done right away for a baseline and you should get another every trimester. I feel the more you do - the better. It's your life, don't let these doctors take a passive role.

Kari

(call me if you ever need to: (404) 217-2883) - Cell phone.

[JAMESFETT]

Hi Kimberly. You're probably just fine, but your concerns about being short of breath need to be addressed by your physician. Hypertension is not usually a part of PPCM, that's a separate issue. Your BP is fine, sounds like. Swelling prior to the last trimester would be concerning and perhaps explains the amount of weight gain you have experienced in first trimester, and you should talk with your doctor about that. If you were stable, the schedule for echos that your doctor has suggested sound fine. If you are not stable, there may be a need to change that schedule. In summary, discuss these issues with your doctor.

James