RALEIGH, N.C. — One of the happiest times in a woman's life can quickly become the hardest. Late in pregnancy or right after delivery, women can develop congestive heart failure. It can happen to women who are otherwise healthy.
Like many new moms, 36-year-old Angela Bethel often felt tired, but when Dylan was just 4 weeks old, she knew her fatigue was not normal.
"I could not catch my breath to take him upstairs," Angela Bethel said.
Bethel thought she just needed a good night's sleep.
"I woke up completely out of a dead sleep. I could not breathe, short of breath," Bethel said.
Bethel had peripartum cardiomyopathy, a weakness of the heart muscle that can affect women during pregnancy or just after delivery. African-American women are among those highest at risk.
"It can present [itself] in a number of ways, from shortness of breath, fatigue, swelling of the feet -- a lot of things that unfortunately mothers have already and so it can complicate the diagnosis," said Dr. George Hamrick, a cardiologist at Rex Hospital.
But those with the disease have more persistent and significant symptoms. The disease is rare, occurring in just 1 in every 3,000 births, but no one sees it coming.
"My pregnancy was a normal pregnancy. My delivery was normal and -- Bam! -- afterwards, here I am," Bethel said.
"Because we don't really know what causes this to develop, it's not necessarily something that's preventable," Hamrick said.
However, it is treatable if diagnosed early. Now, only 35 percent of Bethel's heart functions, but medications and a sodium-free diet lessens her symptoms.
Fifty percent of women will show improvement and regain almost normal heart function after six months, but as high as 20 percent will get worse. They could die or need a heart transplant. Bethel is determined to get better.
"There's no playing because I have to hang around because I have a little one to take care of," Bethel said.
Besides African-Americans, other women at risk are those who have had multiple pregnancies, those who have had twins or triplets, women over 30 and those with high blood pressure.