Heart Stories – Angelique Richardson

When Angelique went into preterm labor at just seven months pregnant, she feared for the lives of the babies she had yet to hold. While her twins gained strength in the NICU, Angelique’s health began to fail. A peripartum cardiomyopathy diagnosis sent her back to the hospital where she and her children fought to live. Here is Angelique’s story.

I never imagined I would be 35 years old with a heart condition. I’ve always tried to live a healthy life by exercising and eating well. Little did I know that this wouldn’t deter my peripartum cardiomyopathy diagnosis and the fight for my life.

On July 21, 2020, I woke up to find my water had broken. This came as a complete shock as I was only seven months pregnant with our identical twin boys. Immediately I called my OB to let them know what happened. They instructed me that I needed to get to the PETU at Pennsylvania Hospital ASAP.

When I arrived at the hospital with my husband, I felt fine with no pain, fluid retention, or shortness of breath. The babies, however, were in imminent danger and I started on a course of magnesium, iron injections, a steroid to help the babies’ lungs develop properly, and fluids. My mind was racing as the doctor explained everything they would be doing. I have always been so cautious throughout each of my pregnancies. They had all made it to full term with no complications. Why was this happening now?

One after another, a parade of doctors and nurses came to my room. The words they told me were devastating – bed rest, premature birth, C-section. I had never experienced anything like this before and it was not a part of my plan. Next came the blood draws, multiple connections to medications, and an iron drip. I was scared out of my mind.

Once the magnesium began, I was placed on bed rest. The goal was to keep the babies inside as long as possible. Luckily, despite the pandemic, my husband was able to stay by my side while we waited for our children’s birth. His presence was a blessing but it couldn’t push away the guilt looming in the back of my mind. While I laid in the bed, the only thing I could think about was what I had possibly done wrong during the pregnancy to end up like this. I ate healthy meals, was very active, and went to every doctor’s appointment. I thought I had done everything right and yet here I was praying for each additional minute I could keep my babies safe inside of me.

Once given the medications, the waiting game began to see how long we could keep me pregnant. For two days, I was on bed rest in constant pain and discomfort. It was at this point that I started having difficulty breathing. The doctor ordered a chest X-ray and echocardiogram to see if this could reveal the cause. Despite the echocardiogram coming back normal, my chest X-ray revealed fluid in my lungs. Upon this discovery, my magnesium was immediately discontinued and they wanted me out of bed. The hope was, once I was able to be up and moving around, my pain and circulation would improve.

Although there was a mild improvement after getting out of bed, the intensity of my contractions had increased drastically. I moved back into the bed where I took Benadryl and morphine for the pain but nothing helped. Every minute another contraction wracked my body. I was starting to feel the urge to push and felt as if the baby’s head was in place for delivery. When they checked, a code was called and they rushed me to the OR.

My body, however, was not going to wait another minute and I began to push. Over the next hour I, vaginally and with no medication, gave birth to my twins, Cobi and Maddox, 23 minutes apart in the labor and delivery room.

After the birth of my sons, a flood of relief washed over me. My babies were rushed to the NICU but we felt assured that they would be okay. I thought that we were through the hard part. Finally, I could focus all of my attention on the health of my children. What I didn’t know was that, in just a couple of days, I would be fighting for my life.

I spent two days in the hospital after the birth and was discharged after my team found me to be in good enough health to return home. Leaving the hospital, however, was bittersweet. Although I would get to reunite with my older children, the twins were still gaining strength in the NICU. When my husband and I went down to see the twins right before leaving I became extremely emotional. I felt like I was leaving them behind.

Once we arrived home, all I wanted to do was see my other children and take a shower. When my mother arrived with three of my children, Christian (14), Carter (6), and Blake (5), I was beyond elated.

After spending some time with my family, I decided it was time for a shower. While I was bathing, however, I instantly did not feel well. I realized the problem was I couldn’t breathe properly and felt extremely anxious. I called my cousin who is a nurse and she advised me to call my doctor immediately. After speaking with my OBGYN’s on-call team, they instructed me to immediately go back to the PETU!

Tears flooded down my face upon learning I had to return to the hospital. I had literally just left that same day. Scared and unsure of what was even wrong with me, I feared I was going to die.

Once my husband and I arrived at the hospital, they began a series of testing to rule out a variety of conditions including pulmonary embolism, GERD, and high blood pressure. All my labs came back normal except for the EKG. The cardiologist on-call ordered an echocardiogram to get a clearer picture of my heart. The results from my echocardiogram revealed that my ejection fraction (heart function) was just 35%.

At the time, I had no idea what this value meant and it wasn’t until the doctor was able to come to explain it that I was able to process the magnitude of my condition – peripartum cardiomyopathy. He explained that, had I not come back to the hospital when I did, I would have died. All of this information was so overwhelming that I began to cry uncontrollably. All I could think about was how close I was to not being there for my children and husband. As my doctor consoled me, he said we should feel happy. My condition was discovered before it was too late and they knew how to treat it. I hoped his words would be true.

At that point, I was informed that I would be admitted. Initially, they told my husband he would not be able to stay with me due to COVID restrictions and my having to have a shared room. Luckily, however, through many efforts, I was able to be readmitted on the postpartum floor allowing me to have a private room that my husband could stay with me in. It was such a blessing having him by my side while I endured this devastating ordeal. He was my best advocate and truly my rock. I couldn’t have done it without his support.

My cardiology team went to work trying to help my heart improve. A heart monitor continuously tracked my heart while I started several medications. I took a Lasix pill along with 2.5 mg of enalapril. Additionally, I had to follow a cardiac diet that included salt and fluid restrictions.

Luckily, there was a bright side to the additional time I had to spend in the hospital. Each and every day I had the opportunity to visit with my twins in the NICU. Seeing them fight every day encouraged me to continue my fight as well. I knew we could get through this.

Over the five additional days, I had to spend in the hospital, they were able to remove 18lbs of fluid from my body. My final echocardiogram revealed that my ejection fraction had increased to 55% and my heart was functioning at a healthy level. On July 30th, I was finally able to go home.

Since I left the hospital, I have tried to maintain my health but I live in a constant state of fear that something will go wrong in my body. The mental load of my diagnosis has wreaked havoc on my overall wellbeing and has definitely contributed to my postpartum depression. Having two new babies, a peripartum cardiomyopathy diagnosis, and postpartum depression has been hard but I am working on getting my life back to normal. My hope is that, by sharing my story, I will be able to use my experience to help bring more awareness to postpartum depression and peripartum cardiomyopathy. There is so much we don’t know about these conditions and we must inform women so they can be advocates for their health.

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