question

[amandabenjamin74123]

I'm just wondering what your input may be. I am 17 weeks pregnant with ppcm baby # 1 and am currently taking methyldopa for BP. My BP is around 140's/90's. My pulse is also high, averaging around 120. My OB doctor doesn't think I need an echo, as I do not have any "symptoms". But he did suggest I ask my Cardiologist if I should be on the Methyldopa, a Beta blocker, or a channel blocker. I called Cardiologist yesterday, still haven't heard back. This being the cardiologist who told me to terminate. What do you think the best approach would be, and do you think it would be important for me to have an echo done just to get a "proven" baseline?

[JAMESFETT]

First of all, I am extremely happy that your EF is normal (at the last echo). There are options that you can work out with your cardiologist and obstetrician:
1)Methyldopa and beta-blockers are both safe during pregnanc. Methldopa is a very old medication, and for the most part other meds have taken its place in treating hypertension. Would you experience equal or better results on the B.P. by changing to a beta-blocker, such as metoprolol XL? That is for you to work out with your doctors.
2)You can monitor blood tests that potentially give an early clue that something has changed in the heart which possibly could lead to decreasing systolic function. Those tests are:
a)CRP. A level of greater than 10 mg/liter has been associated with inflammatory cardiomyopathy, viral myocarditis, PPCM, IDCM, lymphocytic myocarditis. The lab test is inexpensive and could give important information.
b)BNP. A level above the lab " cut-off" could indicate impending left ventricular failure, and offers a good simple lab measure to follow left ventriclar function duriing a subsequent pregnancy in a person who has had previous PPCM.
c)Troponin-T. Elevated in the event of myocardial damage. Of these 3, this is the least sensitive test, and a normal level does not rule out impending trouble.
Of course should any of those 3 be abnormal, a followup echo is indicated. If there are other symptoms, even in the absence of those lab tests, a followup echo is indicated.
So, as you see, there are a variety of options open to you to discuss with your doctors. If they wish to discuss this with me, and with your permission, I am certainly available.

JD

[SerenaWelsh]

Amanda,

I'm happy to hear from you. I thought from one of your previous posts that you had already terminated.
Glad to hear that things are running along smoothely so far!

[julianameng]

I am sorry you are having troubles but so glad to know you are still prego, i thought that you posted that you terminated.
Hope things continue to go well.

[amandabenjamin74123]

i did try to terminate. it's been a while since i've wanted to be on here.

[Erin]

Just wanted to wish you well, Amanda! How are you feeling about things--are you stressed? Excited? Aprehensive? Are you doc's going to work with you okay, or do you think they're going to be frustrating? That's a great invitation from Dr. Fett to have them contact him. I hope everything goes well for you.

[LSmith]

Amanda - I thought I had read that too. I'm praying that everything goes well for you.