Tables Turned - Cardiac Nurse Receives Heart Care During High Risk Pregnancy

In 2020, Tiffany Hujer learned she was pregnant with her first child. Having been diagnosed with a mild heart condition earlier in the year, the 33-year-old Acton resident and her husband Dan prioritized consulting with Melissa Spiel, DO, Prenatal Practice Director at the BIDMC Center for Maternal-Fetal Medicine.

The timing was ideal. Spiel, together with Loryn Feinberg, MD, Director of the Women's Cardiovascular Health Program at BIDMC, had recently formalized the launch of the Cardiovascular Disease and Pregnancy Clinic for women with cardiac problems who are pregnant or want to become pregnant.

"Women with any kind of cardiovascular disease can be at risk during pregnancy," explains Spiel. "Our program brings together a multidisciplinary care team made up of obstetricians, maternal-fetal medicine specialists, cardiologists, anesthesiologists, nurses, social workers and genetic counselors who work closely together to carefully coordinate care and ensure the best possible outcomes for patients like Tiffany."

"I feel honored to share my story," says Hujer, a nurse in the Electrophysiology Lab of the Arrhythmia Service in BIDMC's CardioVascular Institute. "Throughout my pregnancy, Dr. Spiel, together with a team of BIDMC cardiologists led by Director of Vascular Medicine, Brett Carroll, MD, carefully monitored my health. I felt really safe and in good hands." Hujer's healthy baby daughter, Isabella, was born on August 15 at BIDMC.

Both personal and professional experiences had made Hujer aware of the need to take precautions. As a nurse in cardiac care settings for more than 11 years before joining BIDMC's Electrophysiology Lab, Hujer was aware of the strain that pregnancy can put on a woman's heart. And because her mother had been diagnosed with an aortic aneurysm nearly eight years ago, Hujer had already been undergoing regular check-ups to keep an eye on her heart health. Then, through a routine MRI in 2020, she learned that her aorta, the main artery that carries blood away from the heart to the rest of the body, was slightly enlarged.

"It is important to closely monitor even a mildly enlarged aorta during and soon after pregnancy," says Carroll, medical director of BIDMC's Aortic Center. "Whenever the aorta becomes enlarged, there is a higher risk of serious complications including rupture or dissection (a tear in the aorta). Certain medications or approaches to delivery may be appropriate to decrease the risk of complications in some patients." Working with the members of the Cardiovascular Disease and Pregnancy Clinic, Carroll closely monitored Hujer's condition throughout her pregnancy, including ordering a series of echocardiogram imaging tests.

"For women with any type of cardiac disease, whether it's something that has developed over their lifetime or a condition they inherited at birth, it's optimal to meet with a cardiologist and specialty team as early as possible when contemplating pregnancy," says Spiel. "The sooner a woman can get care, the sooner we can develop a plan to keep mother and baby safe and ensure a healthy pregnancy."

Hujer couldn't agree more. "Dr. Spiel was my primary doctor throughout my pregnancy, and she was by my side the whole time. I knew that she was working closely with Dr. Carroll and the interdisciplinary team members and coordinating all of my care." Hujer gave birth to 6-pound, 15-ounce Isabella in the early hours of August 15. "My whole experience was just incredible," says Hujer."I was not only supported by my tremendous doctors but also by an unbelievable nursing staff, who were so professional and caring, and compassionate throughout my hospital stay. As a nurse, I have always put my heart and soul into my job, and it felt great to be on the receiving end of this amazing care. Now, I'm sitting here staring at this beautiful baby."

Tiffany Hujer is an honorary member of the 2021 BIDMC Boston Heart Walk Team which is focused on Women and Cardiovascular Health. Learn more about the 2021 Heart Walk.