Undiagnosed Heart Problems During Pregnancy Can Increase Risk of Aortic Dissection: Study

The failure to diagnose a rare heart condition among pregnant women may increase their risk of suffering a serious and potentially deadly aortic dissection, according to the findings of a new study.

Aortopathy is rare condition, which often goes undiagnosed. However, a study published last month in the medical journal JAMA Cardiology highlights how the undiagnosed heart problem can result in serious complications during pregnancy, including a failure of the aorta walls that can quickly result in death.

Aortic dissections involve portions of the aorta tearing. Blood pools or leaks instead of pumping normally. Patients who experience this condition need emergency lifesaving treatment.

In this new study, an international group of researchers evaluated data on 29 women who experienced emergency hospitalization for aortic dissection related to pregnancy from 1998 to 2018. Most participants had an underlying aortopathy condition, but were previously unaware of the diagnosis. The small group represented 1% of women in the International Registry of Acute Aortic Dissection.

Nearly half of the participants had a type A aortic dissection and 55% had type B. Women experienced aortic dissection during all three trimesters and within 12 days of giving birth.

Aortopathy was not recognized until after aortic dissection occurred in 47% of the women. Overall, nearly 70% of the women who had suffered aortic dissection were ultimately diagnosed with aortopathy.

Roughly three in 100,000 people suffer from this condition every year, and it is more common in older men.

Aortopathy is a disease that affects the aorta, the largest artery in the body. It causes impaired aortic function and can lead to life-threatening complications, including aortic dissection. However, many women are unaware of their aortopathy. Pregnancy places increased strain on the heart, which can exacerbate the condition if undiagnosed and untreated.

Women who have had aortic dissection while pregnant are often later diagnosed with other conditions, such as aortopathy, Marfan syndrome, and Loeys-Dietz syndrome. High blood pressure is also a common risk factor.

Nearly 20% of aortic dissections among women younger than 35 are associated with pregnancy.

Researchers emphasized the need for quality prenatal care, especially for women with known aortic disease. Both maternal and fetal risk should be assessed. Women at risk should receive ongoing monitoring and testing before pregnancy, during pregnancy and postpartum.

“Most pregnancy-related aortic dissection is due to an aortopathy often not diagnosed until after aortic dissection,” wrote study authors. “Recognition of underlying conditions and risks for aortic dissection may improve management of pregnancy in women with aortopathy.”