After a difficult first pregnancy, Jen Woleslagle-Stone had concerns going into her second. She tried everything in her power to make this pregnancy less stressful. Little did she know how much worse this pregnancy would be and the heart issues she would face for the rest of her life. Here is Jen’s story.
In November 2018 the two pink lines finally appeared. Admittedly, as much I yearned for a second child, I was not looking forward to another pregnancy. My first pregnancy consisted of horrible nausea, uncontrolled high blood pressure, and a scare with pre-term labor. As a result, I ultimately ended up delivering our first son via emergency C-section in May 2013. My blood pressure never quite resolved; however, medication helped maintain a normal range for years.
I went into my second pregnancy proactive. For instance, we had a baseline urinalysis done at the start of my pregnancy. I also monitored my blood pressure daily. As my blood pressure was steadily increasing each week, my doctor prescribed me a pregnancy-safe medication. Much like my first pregnancy, I was rapidly growing in size. My fundal measurements were always weeks ahead of gestation.
Assuming the increasing fatigue and dizzy spells I experienced were due to my expanding size and a busy schedule, I continued to push through. My blood pressure seemed stable, considering my history, and I had never given much thought to my heart rate. My average readings were typically 120+ bpm while sitting at my desk at work. At each appointment, I presented my data to the provider and they reassured me that everything was normal.
In early June (around 29 weeks) I was dealing with a horrible asthma flare-up (or so I thought). Just as I had with my first pregnancy, I began to experience frequent contractions. I was urged to go to labor and delivery to get checked out. After a few hours of monitoring, it was determined that I was having contractions. Luckily they were not causing any progression. The physician noted my heart rate seemed a little high but was likely due to the extra use of my inhaler over the previous days. I received some medication to help with subduing the contractions and returned to work the next day.
Each day it became increasingly difficult to breathe. I had a constant feeling that I needed to cough, yet it was providing no relief. With my exhaustion, I physically could not keep my eyes open at times. Each time I took a shower I felt as though I was going to pass out. My vision became blurry, my heart was racing and I was unsteady. One evening my husband told me to go lie down and relax. I tried. I had a super active baby boy bouncing around, this nagging cough, and I couldn’t get comfortable no matter the position. Each time I tried to lie down I would feel like I was suffocating. To help, I spent the night trying to get some sleep upright.
The next morning, I told my son and husband I would be right back. Hoping to get a breathing treatment for relief, I went off to urgent care. After having my vitals taken I was immediately hooked up to an EKG. The physician told me the EKG was irregular and concerning and that she was calling an ambulance. Since I was receiving my prenatal care in our neighboring state of West Virginia, I called my husband to come to pick me up and take me there. I was 31 weeks at this point and didn’t want to take any chances.
Upon arrival, my heart rate was 143. I had an ultrasound of my legs done to rule out deep vein thrombosis. Next, a chest x-ray was ordered to rule out a pulmonary embolism. The chest x-ray revealed fluid on my heart and lungs. A bedside echo was immediately ordered, showing a reduced ejection fraction of 19%. An ambulance took me to a higher level hospital across the street.
A room full of medical professionals met me in labor and delivery. Again, the fatigue was so extreme I couldn’t keep my eyes open. Much of the initial experience is a blur. They ushered my husband out of the room as they rolled a crash cart to my bedside. In an attempt to regulate my heart rhythms I was given Adenosine, which essentially stops your heart for a moment.
After my peripartum cardiomyopathy diagnosis, the Cardiac ICU admitted me for about a week. During my ICU stay, I underwent a cardiac MRI and a heart catheterization. Due to being pregnant, I wasn’t able to get sedation for either procedure. These tests only further confirmed the rapid decline of my heart function. When I was stable, I transferred to Labor and Delivery until the birth of my son. Each day my goal was simply to survive. I had discussions with doctors of all specialties, informing me of the potential outcomes for me and my baby – talks of a heart transplant, life support, risks the baby would be facing, etc.
At 34 weeks, the heart failure and maternal-fetal medicine teams both agreed it was the safest option to deliver. I had already known going into this pregnancy that I would be having a repeat C-section. Unlike my previous pregnancy, the cardiology team was on standby outside of the operating room. Also, as a precautionary measure, I was prepped for life support.
The uneventful procedure luckily resulted in the safe delivery of our son. I was sent to a cardiac step-down unit for recovery and our son spent the following weeks in the NICU growing and thriving.
Upon discharge, I followed up frequently with the heart failure clinic until it was evident that my body was responding well to treatment (Entresto, Metoprolol, Spironolactone, and various supplements). By February 2020 my ejection fraction had recovered to 50%. I’m still dealing with episodes of tachycardia, arrhythmias, and now AFib episodes. I will be on medication indefinitely, and the need for further intervention is a possibility.
I feel very fortunate that I fell into the hands of a hospital familiar with PPCM. My hope for the future is that the simple BNP blood test will become part of the routine pregnancy-related tests administered. Early detection is possible!
Do you have a heart story? Share Your Heart Story on This Mommy’s Heart.