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 6 to 12 weeks.

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 include:

According to the American Heart Association, women are more likely than men to experience symptoms less commonly associated with heart attack, such as:

  • shortness of breath
  • nausea or vomiting
  • back or jaw pain

Learn more about heart attack symptoms.

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 87% to 95% of cases of SCAD occur in females. It’s highly associated with pregnancy and the postpartum period.

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 5% of cases of SCAD occur during pregnancy, SCAD accounts for up to 43% of heart attacks during pregnancy and about half of heart attacks during the postpartum period.

Other causes of PAMI include:

PAMI occurs in about 2.8 to 8.1 females per 100,000 childbirths, which is about four times higher than the heart attack rate in nonpregnant, reproductive-aged people.

One of the most reported risk factors is being over age 35 years. Other risk factors include:

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:

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.

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Doctors use a combination of tests to diagnose PAMI and assess the extent of heart damage. These tests might include:

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 include:

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

Learn more about cardiac rehabilitation.

PAMI can be life threatening. The death rate seems to be higher than for heart attacks not associated with pregnancy.

In a 2018 study, researchers reported an in-hospital death rate of 4.5% in the United States between 2002 and 2014. Other studies have reported PAMI death rates between 5% and 11%.

Nearly half of deaths from PAMI occur within the first day of delivery, and two-thirds of deaths occur within the first week.

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 four times more common among pregnant females than non-pregnant females of reproductive age.

What heart disease is associated with pregnancy?

Pregnancy is associated with:

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.