Louisva Carolas, a 35-year-old Brooklyn resident, was healthy, had no history of heart disease, and had no reason to believe she was at risk for heart disease. But pregnancy can act as a stress test for the heart, and shortly after giving birth to her son at NYU Langone Health on February 3, 2024, she was diagnosed with complications she wasn’t expecting.
“I thought once the baby was here and healthy, it would be okay,” Carolas said. “I never thought something like this would happen after that.”
Unexpected developments after delivery
A few days after giving birth, I felt something strange.
Carolas developed postpartum preeclampsia, a condition that causes high blood pressure after giving birth. Initially, her blood pressure appeared stable and she was discharged from the hospital without symptoms. Like many new mothers, she ignored the subtle changes in her body as part of normal recovery and focused on her baby.
But after being advised by her gynecologist to measure her blood pressure at home, Carolas noticed that her readings were steadily rising above the normal range. She returned to the hospital immediately, where she was diagnosed and treatment began.
“It was scary. I didn’t know what was happening to my body,” she said.
The maternal-fetal medicine team at NYU Langone quickly stabilized her blood pressure and monitored her closely. As her symptoms improved, she transitioned to NYU Langone’s Cardio-Obstetrics Program, where she began working with co-director Anais Hausbater, M.D., a cardiologist who specializes in postpartum cardiovascular health.
Led by Dr. Hausbutter and maternal-fetal medicine specialist Christina A. Penfield, MD, MPH, the Cardio-Ostetrics Program brings together experts in obstetrics, maternal-fetal medicine, adult congenital heart disease, and preventive cardiology to care for people before, during and after pregnancy, as well as address long-term heart health. Care extends into the “fourth trimester”, the critical months after birth when complications like Carolus often occur, with specialized follow-up through the Postpartum Cardiovascular Health Program, part of the Cardio-Ostetrics Program.
For Carolus, that caring changed everything.
Rather than treating her symptoms as a one-time complication, Dr. Hausbutter and her team helped Carolus understand that they were early warning signs of future heart disease.
With that in mind, Carolas embarked on a plan to protect her health. Dr. Hausbutter determined that she had developed chronic hypertension (a common long-term effect of preeclampsia) and tried to control her blood pressure with medication.
“We noticed that her blood pressure remained significantly elevated after delivery, which can occur after pre-eclampsia,” Dr. Hausbutter said. “Optimizing blood pressure is important for long-term heart health and for future pregnancies.”
Carolus measured her blood pressure at home, took medication as needed, made lifestyle changes, and continued regular follow-up visits.
“It opened my eyes,” Carolas said. “This wasn’t just about that moment, it was about my future.”
Second pregnancy requires coordinated care
When Caloras became pregnant again, her care plan was shaped by everything her team had already learned. She seamlessly returned to high-risk obstetric care and was managed by Dr. Kristin E. Brown, a maternal-fetal medicine specialist who is a member of the Cardio-Obstetrics Program and Department of Obstetrics and Gynecology, along with Dr. Hausbutter. Her doctors closely monitored her blood pressure and tailored her care throughout the pregnancy, focusing on reducing the risk of complications.
“Incorporating cardiology into pregnancy and postpartum care allows us to better support patients during and after pregnancy,” Dr. Brown said. “Our cardioobstetrics program is designed to be seamless, with coordination at every step of the treatment as cardiologists and maternal-fetal medicine specialists work together.”
This proactive, tailored approach was especially important because people who have experienced preeclampsia in one pregnancy are more likely to develop it again. “To reduce the risk of recurrence, we begin preventative measures early, such as administering low-dose aspirin early in pregnancy,” Dr. Brown said.
On October 30, 2025, Carolus gave birth to a healthy daughter. This time there was no pre-eclampsia and a care plan designed around her individual risks.
Pregnancy may reveal future heart risks
Carolas’ experience reflects doctors’ recognition that pregnancy can provide early insight into long-term heart health.
“Pregnancy is nature’s stress test,” says Dr. Brown. “The heart has to work harder during this time.”
Complications such as pre-eclampsia, gestational diabetes, preterm labor and miscarriage are now understood to be important indicators of future cardiovascular risk.
Hypertension, such as preeclampsia, affects one in eight pregnancies in the United States, and people who experience the disease are two to four times more likely to develop high blood pressure and heart disease later in life.
“These risks don’t go away after birth,” says Dr. Hausbutter. “Decades later, rates of heart disease, heart failure, and stroke are still high.”
A chance to change the future
Many people don’t think about heart disease until later in life, but Carolus’ story shows there’s an opportunity to act much earlier.
Recognizing pregnancy and postpartum complications as warning signs, rather than just one-off events, allows cardiologists to intervene earlier with monitoring, prevention, and long-term care. “The puerperium, or ‘fourth trimester’, is one of the times when the risk of complications is highest, yet many women do not receive continued follow-up after giving birth,” Dr. Hausbutter said.
Dr. Hausbutter encourages postpartum people, especially those who have experienced complications such as pre-eclampsia, to continue monitoring their health at home, including using a blood pressure cuff and staying connected with their care team after delivery.
For Carolus, this early intervention helped protect her long-term health and made her second pregnancy safer and more predictable.
“I want other moms to know: Listen to your body,” she said. “If something doesn’t feel right, don’t ignore it.”
