The Heart of the Matter

I posted a bit recently about how this pregnancy has been an altogether different adventure than my pregnancy with my son. Specifically, I’ve felt sicker, and for much longer. (Twice as long now, and the nausea is still going strong here in my second trimester…signs that it’s a girl?!) Other odd things I’ve had to contend with so far during this pregnancy are rapid heart beat and blood pressure spikes.

It started in the middle of my first trimester, when I noticed that in addition to normal pregnancy fatigue, I found myself working to catch my breath frequently while I was completely at rest on the couch.  This was mostly an annoyance to me, as I had to consciously take bigger breaths and/or sit up in order to get the air my body wanted.  It wasn’t until I started to have warning signs of spiking blood pressure (BP) that I thought to check my heart rate.  (I was familiar with the signs of high BP in pregnancy because I had this and other signs of pre-eclampsia when carrying my son.)  When I began to experience infrequent bouts of dizzyness, blurred vision, and headaches, I dug out my blood pressure cuff and took a reading.  Sure enough, my BP was reaching the ‘danger zone’ of 140/80 at those times, when normally my BP is at the bottom of the normal range. My heart rate was also oddly high- 125 completely at rest. The problem is, it was too early in the pregnancy to officially develop pre-eclampsia, from what I understand; women with high BP before 20 weeks are assumed to have had a pre-existing/chronic case of high BP from before the pregnancy, and I knew that wasn’t the case.  A mystery on our hands, we had.  And physically I ranged from feeling annoyed to feeling miserably sick.

So I checked with my OB, since I had previously been diagnosed with a “sinus arrhythmia” by my primary care doc, to see if these symptoms were explainable and benign in light of that.  She said the pregnancy may actually be causing an additional cardiac abnormality, and in any case, a sustained elevated heart rate could make it difficult to get nourishment to the baby.  So she referred me to a cardiologist to investigate.  The cardiologist set me up with a two week EKG-like heart monitoring system and an echo-cardiogram to spy the heart itself.

Here is my neat heart monitor, complete with three electrodes (two on chest and one on bottom left rib) connected to a pager-like device which collects the data as well as a cell phone which transmits data to a monitoring center when an unusual heart event is observed.  It was pretty cool!  But I had to wear it 24/7 except when showering, so tossing and turning during sleep was a little cumbersome.

Going into all of this, I assumed that my heart was in great shape.  I knew I didn’t have chronic high BP, and I have a history (except recently) of being pretty physically active and working out.  I thought that the cardiologist’s preliminary suggestion that changes in my activity level and food quality (read: McDonalds) while I’ve been battling nausea may have caused all of my symptoms.  I wanted to smack my forehead and admonish myself, “Duh!” when he pointed out that switching from healthy home-cooked meals to mostly frozen and/or fast food caused the sodium in my diet (and therefore my BP) to skyrocket.  But I was truly grateful to have my heart looked at more closely, because the “sinus arrythmia” that I had been quickly diagnosed with last year kind of troubled me….I wanted to know if, long-term, it could cause other problems or put me at risk for overworking my heart. 
Well I got my answers, and it was all good- if surprising- news.  My heart is healthy.  Baby #2 is getting fed just fine, because my elevated heart rate isn’t frequent or sustained.  And apparently, I actually don’t have the arrhythmia I was diagnosed with previously.  Rather, I have both extra and skipped heart beats (or PVCs and PACs).  The doc said that during a particularly long skipped beat, the monitoring center alerted him immediately to be sure I was OK. By that time he knew I was prone to skip beats (which Greg proudly claims occur whenever he walks into the room), so the doc assumed I was still alive.  Ultimately, the doc says they don’t occur frequently enough to cause me or the baby any problems, and they don’t pose any larger health risks. The skipped/extra beats may be more pronounced for me during the pregnancy, especially as it progresses and my heart rate naturally rises.   Now that I know what is causing it all, and that it’s not a danger, I can “breathe easier,” figuratively, and continue to breathe deeper, literally, when I need to.  And I can try to lay off the McMuffins.   

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