When Chelsi S. noticed some swelling in her feet just before and right after she gave birth, she chalked it up to being pregnant. She was glad it was summer so she could wear flip-flops instead of squeezing into sneakers.
“Now, I look at pictures of me from the end of my pregnancy, and I can see there was definitely something wrong,” Chelsi says. “I just didn’t know it.”
As Chelsi’s due date approached, her blood pressure rose suddenly, and the baby’s heart rate dropped. Her doctors recommended inducing labor (using medication to trigger the labor process).
Chelsi went to her local hospital to be induced — on a Thursday. She was in labor for two days, and her healthcare team, concerned she might be hemorrhaging, considered a C-section as she pushed for two hours before her son, Jaxson, finally arrived just after midnight on Sunday.
“It was a lot. It was exhausting,” Chelsi recalls.
Chelsi was happy to be discharged two days later. She headed home to rest and spend time with her baby.
But her challenges weren’t over. Chelsi was about to be diagnosed with peripartum cardiomyopathy (PPCM), a rare form of heart failure that can happen at the end of pregnancy, or just after delivery.
A dangerous misdiagnosis
Back home, Chelsi focused on bonding with her son. Like many new moms, she’d learned a lot about what to expect in the first days with her newborn, and was not focused on the signs of her postpartum health condition.
When she brought Jaxson back to the hospital for a follow-up blood test and found that just walking from the parking lot to the hospital was tiring, Chelsi assumed her experience was normal — especially after her marathon labor and delivery.
“I felt really tired,” Chelsi says.
It was a phone call with her aunt that made Chelsi dial 911.
“We were talking on the phone, and I couldn’t catch my breath,” Chelsi says. “I couldn’t complete a full sentence without gasping for air. My aunt asked if I was okay, and I told her that I felt fine. She said, ‘You’re not fine. I can tell.’ ’’
Chelsi’s aunt insisted she call 911. When the ambulance arrived, Chelsi’s blood pressure was alarmingly high. She was taken to a nearby hospital.
In the emergency room, doctors ran a few blood tests and gave Chelsi a diuretic, medicine that helps remove excess fluid from the body — by now, Chelsi’s eyes were almost swollen shut.
Because she’d recently given birth, doctors transferred Chelsi back to the labor and delivery unit of her maternity hospital for further evaluation. While Chelsi had a positive experience with her birth team during her difficult labor, the hospital didn’t specialize in high-risk pregnancy care or pregnancy-related heart conditions.
“The doctors thought I was doing OK,” Chelsi says. “But that night, I woke up to a whole respiratory team in my room. They asked, ‘How are you feeling?’ I said OK. And they said, ‘OK, well, your heart’s beating out of your chest.’”
Chelsi told them she didn’t feel anything like that. “I had been sound asleep,” she says.
Chelsi was transferred to the cardiac unit. There, she was told she had pneumonia. Then she was transferred yet again, this time to the hospital’s mother and baby unit, where baby Jaxson would be able to join her. The next day, she was discharged with instructions to schedule a follow-up appointment with her OB-GYN.
To Chelsi, none of this felt right. Pneumonia, even combined with her recent, strenuous birth experience, didn’t seem to fully explain her symptoms. She felt as though her concerns had been dismissed.
Temple’s specialists offered answers
Chelsi’s OB-GYN appointment was for the following Thursday, but by Wednesday, she knew something was very wrong.
“I could feel my chest getting tight, and I could feel my heart beating out of my chest,” she says.
This time, after consulting with a family friend, Chelsi went to the emergency department at Temple University Hospital — Jeanes Campus. Doctors there asked Chelsi about her symptoms, listened to her concerns, and performed another round of blood tests.
Chelsi was told she needed another transfer — but this time, it was to the highly specialized care of the team at Temple’s cardio-obstetrics program. Their expertise with complex pregnancies that involve cardiovascular concerns is unrivaled in the region.
“At Temple, I saw cardiologist Deborah L. Crabbe, MD, FACC, FAHA. She listened to me when I told her how I felt,” says Chelsi. “The doctors looked into where all the fluid in my body was really coming from, instead of assuming it was because I just had a baby.”
Chelsi’s heart was monitored closely, and she underwent further testing, including echocardiograms, to establish the cause of her problems. They promptly made the accurate diagnosis that eluded other doctors and hospitals.
“Dr. Crabbe told me I had heart failure, not pneumonia,” says Chelsi.
The healing power of being heard
When Chelsi got to Temple, her condition was severe. Her ejection fraction (EF) was under 45%, when it should have been above 50%. EF, a metric used to diagnose heart failure, measures how much of the blood in the heart is squeezed out with each heartbeat. In Chelsi’s case, she had peripartum cardiomyopathy (PPCM), a rare type of heart failure associated with pregnancy and recent birth.
“Dr. Crabbe wasn’t sure if my heart would return to normal functioning,” Chelsi says. “She wasn’t sure if I would be able to have another child down the road.”
As a rare, postpartum condition, there’s limited research available about PPCM. More studies are needed to offer answers about the most effective treatments — and the long-term effects PPCM has on a patient’s heart health. That’s why Temple is participating in REBIRTH, a landmark clinical trial centered around a potential treatment for PPCM.
In the meantime, Chelsi and other pregnant people and new mothers can count on getting the best-possible, expert care at Temple.
And under the care of Dr. Crabbe and her colleagues from the Cardio-Obstetrics team including Estefania Oliveros, MD, MSC, and Laura Hart, MD, FACOG, Chelsi began to recover. She could go to the bathroom on her own, take her own meds, and have a conversation without getting breathless.
“After I left Temple, I went home with no swelling or anything,” she says. “I could walk again. I could actually fit in my shoes!”
Today, Chelsi has regained normal heart function. While she initially needed four different heart medications to manage her condition, now she only has two prescriptions — both for blood pressure. And, almost two years after her diagnosis, her blood pressure is normalizing as well.
“We’re waiting for some test results, and I think Dr. Crabbe will start pulling me off these last two medications soon,” says Chelsi.
She needs a healthy heart to keep up with the workout that is parenting.
“My little man is living his best life,” says Chelsi. “He’s a typical toddler, running around everywhere.”
Given her successful recovery, her care team says that Chelsi could choose to have another baby in the future, although she’ll need support and monitoring from cardio-obstetrics specialists to support a safe and healthy pregnancy.
Looking back at what happened, Chelsi’s advice to other new parents is clear: “Listen to your body. Get checked, because you never know.”
Chelsi is most grateful that she got to Temple in time and found doctors who made her feel heard and understood.
“They focused on why I wasn’t feeling right and figured out what I needed to get better,” Chelsi says.
Helpful Resources
Looking for more information?