Peripartum cardiomyopathy is a rare form of heart failure that occurs during the last month of pregnancy up to 5 months after giving birth. One woman shares her story to raise awareness.

Leah Riegert was the last person anyone would expect to have heart issues. Young and healthy, the 32-year-old has always been very active.

“I was one of those crazy people who would get up at 5 a.m. and go to the gym before work,” she says, “and have a green smoothie each morning and grilled chicken and vegetables for dinner.” She and her husband were leading “a relatively boring but super-healthy lifestyle,” she jokes.

Riegert’s first pregnancy was also off to a great start. Still exercising and eating healthy, she felt good. But in 2019, about a month before delivery, some things started feeling off. Her blood pressure spiked and she noticed her feet were unusually swollen. While worrisome, both are somewhat typical symptoms of pregnancy and her doctor assured her it was nothing to worry about.

But immediately after giving birth to daughter Eloise, she noticed that every time she spoke or laughed, she needed to cough. Her conditioned worsened and six days after delivery, Riegert found herself having difficulty breathing while lying down. Her heart rate skyrocketed and her blood pressure reached 180/100 millimetres of mercury — almost twice her usual reading.

At her husband Ryan’s urging, Riegert went to an urgent care centre in Liberty Township, Ohio. She was referred to a hospital immediately, where after undergoing some tests, doctors diagnosed her with peripartum cardiomyopathy, a rare form of heart failure.

“I was heartbroken,” she recalls. “I asked them if they were sure they had the right blood work. I have no risk factors, no history of heart disease in my family, none of that.”

Peripartum Cardiomyopathy, a Rare but Serious Condition
With peripartum cardiomyopathy, the chambers of the heart enlarge and the muscle weakens, leading to less blood flow and an inability to meet the body’s demands. It generally occurs during the last month of pregnancy up to five months after giving birth. The condition is rare, with about 1,000 to 1,300 cases in the United States each year, according to the American Heart Association (AHA).

Peripartum cardiomyopathy can be difficult to detect because symptoms often mirror those of third trimester pregnancy, including shortness of breath and swelling. Other symptoms can include fatigue, heart palpitations, increased urination at night, and low blood pressure.

While the underlying cause of peripartum cardiomyopathy isn’t known, researchers believe it may have something to do with inflammation of the heart muscle. This may be caused by a prior viral illness or abnormal immune response. Genetics may also play a role.

Risk factors for peripartum cardiomyopathy include obesity, a history of cardiac disorders, smoking, alcoholism, multiple pregnancies, being African American, and poor nourishment, notes the AHA. Still, as in Riegert’s case, it can happen to someone without these risk factors.

Women diagnosed with peripartum cardiomyopathy are typically treated with a combination of medications and lifestyle changes. These include adhering to a low-salt diet, monitoring weight, quitting smoking, and not drinking alcohol.

Many women recover normal heart function, while others progress to severe heart failure.

A Long but Worthwhile Road to Recovery
For Riegert, the diagnosis of peripartum cardiomyopathy initially meant spending four days in the hospital’s intensive care unit. Doctors were able to stabilize her and send her home. But the day after her discharge, more bad news followed. Her husband noticed the right side of her face droop and she couldn’t speak.

Riegert was flown back to the hospital by helicopter where doctors determined she’d had a stroke. She needed a thrombectomy, a surgical procedure that removes a blood clot from the brain.

The ordeal would take months to recover from. “I had so much difficulty with fine motor movements,” she says. “Using a fork was so challenging. Handwriting was just impossible at the time.”

Riegert also had difficulty saying what she was thinking. “That was very abnormal for me,” she says. “I’m a psychologist so I talk for a living. The fact that I couldn’t verbalize my words was pretty excruciating at the time.”

But Riegert had a strong support system as she underwent treatment and physical therapy, with lots of assisted walking on a treadmill and learning how to use her right hand again. Her husband handled Eloise’s late-night feedings so she could get much-needed rest. Friends and family helped out, too.

And the biggest motivation to push through recovery was her new-born. “I had a daughter now who I wanted to see grow up,” Reigert says. “I wanted to make it to her first birthday, her second birthday, her twentieth birthday. I wanted to get back to at least a level of my previous functioning so badly for her and for my husband.”

Riegert did even more than that. Now, she’s back to being active and feeling healthy once again.

“I’ve essentially been able to regain all that I have lost, and that has been incredible,” she says. “I’m back exercising. I’m able to run again. My activities are essentially limitless at this point.”

She’s sharing her story as part of the AHA’s Go Red for Women "Real Women" campaign to raise awareness of the heart risks to women, particularly during pregnancy.

What to Know About Pregnancy and Heart Health
“I’d want women to know that after giving birth, you need to make sure that you’re taking care of yourself,” says Riegert. “After having a baby, I think all of our attention tends to be on the cute baby and we kind of put ourselves on the back burner. So, if you’re not feeling well or if you’re not feeling right, go to the doctor. Know your numbers,” she says — meaning your blood pressure, cholesterol, blood sugar level, and body mass index (BMI). “And make sure you’re talking to your doctors about heart health, especially when you’re pregnant, because pregnancy puts so much strain on our bodies.”

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