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Norma Jean
06-13-2008, 02:59 AM
Can a pregnant woman with coronary heart disease have a heart attack during labor and die fromthat or from a torn aorta? or if not, what causes a pregnant woman with heart disease to die in labor?

Silver King
06-13-2008, 03:16 AM
She could bleed to death. Even healthy women sometimes succumb to too much blood loss during delivery.

Your heart attack scenario doesn't sound too far-fetched at all. Anyone can die of heart failure at any time, with or without the complications associated from coronary heart disease.

(Please note that's only my opinion, as I am not a medically trained professional.)

HeronW
06-13-2008, 03:27 AM
Labor puts a tremendous strain on the body, hormones are all over the chart, stress and pain levels are high. Add a serious heart condition and the mother-to-be can easily have that heart attack during delivery--whether she's sedated topically or general.

Norma Jean
06-13-2008, 04:16 AM
Can she die from the heart attack though or even tear her aorta from the high stress and high blood pressure?

Polenth
06-13-2008, 06:57 AM
Can she die from the heart attack though or even tear her aorta from the high stress and high blood pressure?

Yes, she could die from a heart attack.

The torn aorta thing is a different kettle of fish. They're normally caused by long term high blood pressure, rather than a short burst of stress. It can lead to heart attacks (rather than the heart attack leading to the torn aorta).

Personally, I wouldn't give a character with heart disease a torn aorta. I'm sure some poor souls have had both at once, but in a book, it sounds a bit melodramatic to have too many ailments at once. She only needs one to raise her heart attack risk.

Horseshoes
06-13-2008, 07:18 AM
'coronary heart' is as redundant as 'fiction novel'

Most torn aortas are not the aorta that goes into the heart, but rather the abdominal aorta.

A Hx of heart Dz in a pg woman certainly presents a high risk scenario. Make her go eclamptic, essentially stroke from hypertension, and you're not only believable, but most likely.

rugcat
06-13-2008, 07:47 AM
I'm not a doctor, but...

"Coronary heart disease" is more accurately called coronary artery disease, and a "heart attack" is the usual layman's term for a Myocardial Infarction.

The coronary arteries narrow, usually due to the buildup of plaque, and when a piece becomes dislodged it can obstruct the artery completely. Without blood flow, a section of the heart muscle dies, and if it's extensive enough, it can disrupt heart rhythm and lead to a fatal heart arrhythmia.

It could certainly be triggered by the intense stress of labor. There would have to have been an underlying problem already present, but often the first synptom of CAD is sudden death.

Actual structural defects in the heart itself could also lead to sudden death from arrhythmia, due to unaccustomed stress.

Joycecwilliams
06-13-2008, 11:05 AM
A friend of mine's wife died from vomiting, while in labor it went back down her throat and she drowned in her vomit.

Kitty Pryde
06-13-2008, 07:58 PM
She could have an undiagnosed genetic disorder called Marfan Syndrome (http://en.wikipedia.org/wiki/Marfan_syndrome). It can be very hard to diagnose, because it can sometimes cause only a few minor problems and it can cause aortic dissection. I know a woman who has had dissection (aortic tear) three separate times. If she wasn't rushed to surgery immediately, she would have died. I quote wikipedia.


During pregnancy, even in the absence of preconceived cardiovascular abnormality, women with Marfan syndrome are at significant risk of acute aortic dissection, which can be lethal if untreated. For this reason, women with Marfan syndrome should receive a thorough assessment prior to conception, and echocardiography should be performed every 6-10 weeks during pregnancy, to assess the aortic root diameter. Most women however tolerate pregnancy well and safe delivery is possible.

SouthernFriedJulie
06-14-2008, 03:49 AM
I had 3 minor heart attacks in labor, but as you can see, I'm still here. Yes, it is possible to have one during labor...I have no clue about a torn aorta.

dolores haze
06-14-2008, 04:15 AM
Are her doctors aware of her heart problems? If so they probably wouldn't allow her to labor. They might schedule a caesarian before the due date.

When I worked in L&D we had one mother die (of heart failure) on the table during a Caesarian. The baby survived. It was an awful, awful night. I called the code. When the crash team arrived they couldn't believe it - it was very, very unusual for them to be called to L&D. At first they thought it must be a mistake. They rushed into the OR without scrubbing in. They couldn't save her. The screaming of the family, the staff could barely function through the tears, and the sound of that little baby crying - I can't begin to convey the grief of losing a woman in childbirth.