Trust in Experts Helps a Cardiac Patient Navigate High-Risk Pregnancy

Learning you’re expecting your first child is one of the most exciting moments in life. But for 37-year-old Natalie Muniz, the good news was tempered by worries about a heart problem treated long ago.

At age 13, Natalie successfully underwent open-heart surgery at The Mount Sinai Hospital for subaortic stenosis—meaning the flow of blood from the heart’s pumping chamber was restricted. With help from doctors, she fully recovered and remained diligent about heart health. However, in the past several years “life got in the way,” and she had not followed up with her cardiologist.

When Natalie discovered she was pregnant in late 2019, her primary care physician at another hospital referred her to a cardiologist because of her heart history. The cardiologist suggested she terminate her pregnancy because complications could arise from her heart condition.  Natalie was devastated. She reached out to the Director of Adult Congenital Heart Disease at Mount Sinai, Ali N. Zaidi, MD, for a second opinion. “He was able to calm me down,” she says. “Even his voice is soothing.” He scheduled an appointment to meet with Natalie the following week and reassured her, “We’re going to get you through this pregnancy.” Dr. Zaidi referred Natalie to a high-risk OB-GYN physician, Lauren Ferrara, MD, for her delivery. 

While she was fearful, Natalie put her trust in Dr. Zaidi’s hands. In April, he advised Natalie to stay home as much as possible—both because of her high-risk pregnancy and because the COVID-19 pandemic was at its height—and she was managed through a combination of telemedicine and in-office visits.

On June 20, Natalie delivered a healthy baby boy with her boyfriend by her side. She held him for just a few minutes, then was separated from her newborn for two days, so doctors could monitor her health in the cardiac intensive care. Dr. Zaidi mentioned this would happen, so Natalie was disappointed, but not surprised.

Medical advances over the past 30 years have made it possible for women with all forms of congenital heart disease to live long lives and have children of their own, Dr. Zaidi says, but they may have specialized medical needs as they transition from childhood to adulthood. For this high-risk group of patients, Mount Sinai has developed an ACHD and Maternal and Fetal Medicine Clinic. Mount Sinai’s expertise in the field was recognized in November 2020, when the ACHD was accredited by the Adult Congenital Heart Association as a Comprehensive Care Center, one of just three programs in New York State and 36 nationwide with this designation.

Natalie is overjoyed that her labor and delivery went so smoothly. “Dr. Zaidi was there throughout the entire process. I trusted him and his team fully. Even though I was scared, I knew if anything was to happen they were going to take care of me.”