Cardiologist makes critical diagnosis of peripartum cardiomyopathy after new mom has her baby

Mom to a newborn, Amanda Slayton dismissed her breathing issues as seasonal asthma and allergies. And since swelling often accompanies pregnancy, her swollen legs seemed logical too

After 10 years of trying for a second child, Amanda Slayton and her husband, Scott, were jubilant when they conceived their son Seth. Born in February 2018, he is every parent’s prayer — happy, healthy and undemanding.

In ways they couldn’t have predicted, their baby’s good nature has been a godsend to the Slaytons. Less than a month after Seth was born, Amanda started having extreme shortness of breath. When Seth needed to be nursed, she struggled to walk the short distance between her recliner and his crib.

Amanda dismissed her breathing issues as seasonal asthma and allergies. And since swelling often accompanies pregnancy, her swollen legs seemed logical too.

“I was a licensed practical nurse for 12 years,” Amanda said. “Nurses diagnose themselves all the time.”

At one point, the 39-year-old considered how much her symptoms resembled congestive heart failure, but she quickly discounted the thought, believing she was too young for such a diagnosis. Besides, she had a new baby and a 10-year-old son to care for, so she soldiered on.

Peripartum cardiomyopathy is rare and can be tough to spot

One morning Amanda’s breathing became so labored that she asked a relative to take her to Norton Audubon Hospital from the couple’s home in Pleasure Ridge Park. After a battery of tests and efforts to get her breathing under control, she was admitted to intensive care with peripartum cardiomyopathy, a rare form of heart failure that can start near the end of pregnancy or soon after.

Like any muscle, the heart gets bigger when it is overworked, and Amanda’s enlarged heart was only pumping at 10% to 15% of its normal capacity. Left untreated, it could have been fatal.

“Sometimes doctors can be thrown off the trail by symptoms of shortness of breath, fatigue and swelling, which are not uncommon during pregnancy,” said Amanda’s cardiologist, Kelly C. McCants, M.D., executive medical director of the Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program and executive director of the Institute for Health Equity, a Part of Norton Healthcare.

When Dr. McCants first met Amanda, she was scared and anxious to get back to her family at home.

“We used some of the latest techniques and protocols to test her heart and were able to give her a little more encouragement,” Dr. McCants said.

An MRI revealed that she had no scar tissue in her heart muscle — an excellent indicator for a full recovery.

Treating patients like family

Once stabilized, Amanda began her journey back to health through the Norton Heart & Vascular Institute Myocardial Recovery Program. The program has a unique feature that researchers consider a key factor in successful recoveries: Patients see their heart specialists with greater frequency.

“Early on, we were seeing Amanda on a weekly basis, and as she improved, we began to space her visits out to every two weeks,” Dr. McCants said. “We’ll continue to space them out even further in the future.”

Both patient and physician are pleased with Amanda’s progress. She has returned to work and her normal routines thanks to treatments that restore the heart to its normal size and maintain its rhythm. She may always need medication to keep her heart healthy, but Amanda is on track for a full recovery.

Dr. McCants’ optimism and competence buoyed Amanda’s spirits when she felt like her world was falling apart.

“I just love him,” she said. “When he asks how I’m feeling, I know that he genuinely cares about me.”

According to Dr. McCants, Amanda is one of the many high spots in the early days of the Advanced Heart Failure & Recovery Program, which manages patients with the most serious heart conditions, including those who need sustained life support (mechanical circulatory devices) or a heart transplant.

“I try to treat patients like they’re family,” he said. “It’s hard enough to deal with a heart failure diagnosis. The physician and team taking care of you should make sure that you don’t feel like just another patient.”

When to refer a patient

Some signs a patient may need to be referred to a cardiologist:

  • Racing heart
  • Blood pressure dropping when patient stands up
  • Patient experiencing signs and symptoms during the last trimester that don’t seem normal for the patient’s pregnancy
  • Shortness of breath and swelling continue after the patient gives birth

The prognosis is best when peripartum cardiomyopathy is diagnosed and treated early. Fortunately, despite a high risk of recurrence in subsequent pregnancies, many patients with peripartum cardiomyopathy recover within three to six months of disease onset.

This content was reviewed by Kelly C. McCants, M.D., executive medical director, Norton Heart & Vascular Institute Advanced Heart Failure & Recovery Program, and executive director, Institute for Health Equity, a Part of Norton Healthcare.

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