Marina Gray

Photo courtesy of Marina Gray

Marina Gray had been told she probably shouldn't have children. She was born with a congenital heart defect, a hole in the wall between the right and left ventricles of her heart, called a ventricular septal defect (VSD). The defect was surgically repaired by placing a patch across the hole when Marina was 9 years old.

Marina had no symptoms until, at age 35, she began experiencing palpitations, and a disturbance in the rhythm of her heart (arrhythmia) was detected. Her local physician told her the patch between the ventricles would need to be replaced.

Marina asked Mayo Clinic for a second opinion and learned that the patch was fine; no surgery was needed. Carole Warnes, M.D., Marina's cardiologist and director of the Adult Congenital Disease Clinic at Mayo Clinic, told Marina the problem was caused by a leaking tricuspid valve (tricuspid regurgitation) which had probably been damaged a little at the time of her previous surgery. Blood was leaking backwards in the right side of the heart causing the right-sided chambers to dilate and become more irritable, resulting in rhythm disturbances. Dr. Warnes also gave Marina some very good news — that it would be possible for her to have children.

"Many patients with congenital heart disease are told they can't have children," says Dr. Warnes. "Pre-pregnancy counseling and evaluation at a clinic specializing in congenital heart disease and working with a high-risk obstetrician, is absolutely essential," says Dr. Warnes.

"My husband and I were thrilled when we first learned I was pregnant," says Marina. During the first trimester, she had brief episodes of a heart rhythm disturbance called supraventricular tachycardia (SVT), a condition that causes the heart to pump at a rate of 150 to 200 beats per minute.

"During SVT a person feels short of breath — as if they were running a race. If it persists, the heart cannot function efficiently and patients are vulnerable to fluid overload and possible heart failure," says Dr. Warnes.

"The bouts of SVT were frightening and tiring. Of course, I was also very hormonal then and dealing with the early symptoms of pregnancy," says Marina.

"Dr. Warnes and her nurse, Doug Kocer, kept me focused and calm, which I needed to have a successful pregnancy. She and Doug always took time to respond to my concerns in person and by phone. They also have a terrific sense of humor and tried to help us with baby names when my husband Will and I could not agree," says Marina.

"For women who have congenital heart disease and are contemplating pregnancy, I would urge them to go to a reputable congenital heart clinic like Mayo so that they are fully aware of the possibilities and risks," says Marina. "During pregnancy, definitely get the best prenatal care as well as cardiac care. Rest as much as possible and make plans to have someone stay with you after the baby is born. My husband was as overwhelmed as I was with a new baby so it was great to have my mom with us. I did not start to feel well until four weeks postpartum and was grateful to have 24-hour help during that time."

"In addition to a high-risk obstetrician, a woman with congenital heart disease needs to have her cardiologist follow her carefully through the pregnancy and around the time of delivery. The pumping chambers of the heart may not be able to tolerate the increased blood volume and work that pregnancy imposes, and the baby may need to be delivered early," says Dr. Warnes.

Beckett Gray was born just two weeks early on August 21, 2003. He weighed 7 pounds 7.5 ounces and was 20 inches long. Tests confirmed Beckett showed no signs of a congenital heart defect.

"I carried my baby successfully to 38 weeks; term is 40 weeks. My son and I went through quite a journey together. Beckett brings us such joy," says Marina. "Each gummy smile is a terrific reward."