Heart Conditions Could Raise Risk of Torn Aorta During Pregnancy

THURSDAY, Oct. 22, 2020 — Pregnancy can increase the risk of a rare, dangerous heart condition called aortic dissection, researchers report.

This is especially true for women with underlying heart conditions that can go undetected.

Aortic dissections — which affect 3 in 100,000 people per year — cause the layers of the aorta to tear, and blood to pool or leak instead of flow normally. Patients require lifesaving care.

Researchers analyzed data from 29 women who were unexpectedly hospitalized for aortic dissection while pregnant. Most already had a heart condition that hadn’t been diagnosed in many cases.

Aortic diseases and conditions such as Marfan syndrome or Loeys-Dietz syndrome are often found in women who have an aortic dissection while pregnant, the researchers said. But they added that high blood pressure, the most common risk factor in the general population, may also be a factor.

The researchers found that 19% of aortic dissections in women younger than 35 were associated with pregnancy. That means a woman already predisposed to have a dissection is more likely to have one during pregnancy, possibly due to hormones and changes to the body during pregnancy and postpartum.

Women in the study had aortic dissections in all three trimesters of pregnancy, as well as within three months after giving birth, but most cases occurred in the latter part of pregnancy and immediately after.

Pre-pregnancy care for a woman with known aortic disease would include evaluation of maternal and fetal risk, counseling and possible genetic testing, followed by ongoing monitoring and testing, study co-author Dr. Melinda Davis, a cardio-obstetrics expert at University of Michigan Medicine, said in a university news release.

Aortic dissection is most often seen in older men, but this study shows the importance of careful monitoring of heart conditions during pregnancy, according to Davis and her colleagues.

The study was published online Oct. 14 in the journal JAMA Cardiology.

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