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Heart & Cardiology/AV heartblock type 2 and pregnant

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Question
I am 35 years old and was diagnosed with AV Heartblock Type 2 a few years ago. I do not have a pacemaker, but am frequently tired, also live in a very high altitude location. I just found out I am pregnant, about seven weeks... the doctor wrong see me until 12 weeks, I guess I am just nervous and wondering if I should demand an appointment? I live in a very small town and an also nervous about having a qualified doctor. Are there specific questions I should ask? Or things I can do now to help a healthy pregnancy, besides the norm?

Answer
There are two types of second degree AV block, Type 1 (Mobitz I/Wenckebach) or Type 2 (Mobitz II).  One often requires a pacemaker (Type 2) and one oftendoesn’t (Type 1).  We say “usually” because it is patient-dependent and each case can be different.  I will assume you have a Type 2 second degree AV block that didn’t necessarily require a pacemaker – probably because you are young, you are aware of the diagnosis, and you havent been told different. Of course without knowing your case fully I don’t know that for sure.  

A potential issue would be in the event that medications are used for high blood pressure during pregnancy; you will need to avoid AV nodal blocking agents because they could potentially make your heart block worse. Hopefully you wont run in to that.  This would also include the medication alpha-methyldopa, which is commonly used during pregnancy for high blood pressure.  

Waiting until your 12 week appointment should be fine if you haven't been told different by your doctor and you don't have symptoms such as out of proportion tiredness, dizziness or passing out. If you have those symptoms you need to be evaluated quicker. Just make sure your doctor knows about your heart conduction abnormality from now and depending on the details of your diagnosis they will have some idea of the urgency and the need for further evaluation such as assessing the response to exercise. Other than that, your pregnancy should follow a normal course.

Hope that was helpful,  

Heart & Cardiology

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Mustafa Ahmed MD

Expertise

Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

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Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

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http://blog.myheart.net

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Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

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MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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