A postpartum heart attack occurs when blood flow is blocked to part of your heart in the months after childbirth. Hormonal changes seem to increase the risk of heart attack during this period.
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Most heart attacks are associated with atherosclerosis, which is plaque buildup inside your blood vessels over many years. Arthrosclerosis is highly associated with smoking and physical inactivity.
Heart attacks during and after pregnancy seem to be less often related to atherosclerosis.
The main cause of pregnancy-associated heart attacks seems to be spontaneous coronary artery dissection (SCAD). SCAD is a tear in the wall of an artery in your heart. It’s thought that hormonal changes during and after pregnancy might increase the risk of SCAD.
This article examines postpartum heart attacks in more detail, including symptoms, causes, and treatment.
A postpartum heart attack is a heart attack that occurs shortly after giving birth. The definition of the postpartum period varies among studies but often ranges from
A heart attack, medically known as a myocardial infarction, is when part of your heart muscles doesn’t receive enough oxygen due to a disruption in blood flow. This lack of blood supply can lead to permanent heart damage or death.
Warning signs of a heart attack
- chest pain that feels like:
- uncomfortable pressure
- squeezing
- fullness or pain
- pain in one or both:
- arms
- back
- jaw
- stomach
- shortness of breath
- cold sweat
- nausea
- lightheadedness
According to the
- shortness of breath
- nausea or vomiting
- back or jaw pain
Heart attacks during or shortly after pregnancy are called pregnancy-associated myocardial infarction (PAMI).
The main cause of PAMI is SCAD, or the sudden tearing of an artery wall in your heart. About
It’s thought that high progesterone levels during pregnancy and rapid changes of hormones at birth play a role in the development of SCAD in pregnancy.
Although only about
Other causes of PAMI
- atherosclerosis in about 27% of cases
- blood clots in about 17% of cases
- coronary artery spasms in about 2% of cases
PAMI occurs in about
One of the most reported risk factors is being
- cigarette smoking
- high blood pressure
- diabetes
- hyperlipidemia
However, these risk factors seem to be less common in females who develop PAMI than in females who develop heart attacks not associated with pregnancy.
Other potential risk factors may include:
- high blood pressure during pregnancy (preeclampsia)
- giving birth to two or more children at once
- thrombophilia, a condition that makes you prone to blood clots
- blood transfusions
- postpartum infections
According to a 2022 review of research, the rates of PAMI seem to be about four times higher in the United States than in Canada or Europe. This is possibly due to higher rates of risk factors and delays in seeking medical care from a lack of insurance coverage.
Black women also have a greater risk of PAMI. PAMI rates are higher in this group possibly due to higher rates of associated risk factors.
Language matters
You’ll notice we use the binary term “female” in this article. While we realize this term may not match your gender experience, this is the term used by the researchers whose data was cited. We try to be as specific as possible when reporting on research participants and clinical findings.
Unfortunately, the studies and surveys referenced in this article didn’t report data for or may not have had participants who are transgender, nonbinary, gender nonconforming, genderqueer, agender, or genderless.
Doctors use a combination of tests to diagnose PAMI and assess the extent of heart damage. These tests might include:
- a review of your personal and family medical history
- a review of your symptoms
- a physical exam
- chest X-ray
- electrocardiogram to measure your heart’s electrical activity
- blood tests to look for associated biomarkers, such as troponin
- imaging tests, such as:
- optical cardiac coherence tomography
- intravascular ultrasound
A heart attack always requires emergency medical attention. Treatment for a heart attack aims to restore blood flow and help your heart heal. It can involve a combination of medications, cardiac rehabilitation, and surgery.
Medications
Medication options can
- angiotensin converting enzyme (ACE) inhibitors
- angiotensin II receptor blockers
- angiotensin receptor neprilysin inhibitor
- anticoagulant and antiplatelet drugs
- aspirin therapy
- beta-blockers
- combined alpha and beta blockers
- calcium channel blockers
- cholesterol-lowering medications
- vasodilators
Long-term management of SCAD often includes a combination of aspirin and beta-blockers.
Learn more about medications for heart attacks.
Surgery
If surgery is required, you may receive:
- Open-heart surgery: During open-heart surgery, a surgeon may perform a coronary artery bypass where they create a new passage for blood using a blood vessel from another part of your body.
- Percutaneous coronary intervention (PCI): A PCI is a minimally invasive procedure. It involves placing a stent with a long, thin tube inserted into your bloodstream.
Cardiac rehabilitation
Cardiac rehabilitation is a program designed to help your heart regain its strength. It involves a combination of:
- exercises
- education
- counseling
PAMI can be
In a 2018 study, researchers reported an in-hospital death rate of
Nearly
Are heart attacks common in postpartum?
Heart attacks are estimated to occur in 1 out of every 16,000 deliveries, reports a 2018 study.
Researchers also estimate that heart attacks occurred in 1 in 12,400 females hospitalized during pregnancy or shortly after pregnancy.
Is pregnancy a risk factor for heart disease?
Pregnancy can increase the risk of heart disease even if traditional risk factors are not present. Heart attacks are about
What heart disease is associated with pregnancy?
Pregnancy is
- cardiomyopathy
- acute coronary syndrome
- SCAD
- heart attack
- valvular disease
Heart attacks seem to be more common in females in the postpartum period than in females who haven’t recently been pregnant. It’s thought that the increased rate is due to hormonal changes during and after pregnancy.
Most heart attacks in the postpartum period occur in the day or week after pregnancy. Seek emergency medical attention if you suspect you or someone with you is having a heart attack.