Casey Gould had always dreamed of becoming a mother, but her journey was fraught with challenges. After enduring three miscarriages and unsuccessful infertility treatments, she and her husband decided to stop their attempts in January 2024. Surprisingly, just a month later, Gould discovered she was pregnant.
Initially filled with anxiety, Gould found her pregnancy to be a pleasant experience. She relished the feeling of her baby moving and, despite experiencing some swelling late in her pregnancy, her doctors reassured her that everything was fine. When she went into labor on November 1, 2024, she felt nothing but excitement at the prospect of meeting her son.
After a lengthy 36-hour labor, Gould began to sense that something was amiss. Although her vital signs were stable and an epidural was managing her pain, she experienced an overwhelming sense of dread. “I was telling myself not to freak out, and then I saw, like, a black shadow in the corner of the room,” she recalled. This unsettling vision prompted her to alert her doctor and a nurse, exclaiming, “Something’s wrong. I think I’m about to die.”
Shortly after her alarming statement, her son’s heart rate dropped, leading to an urgent transfer to an operating room for an emergency C-section. Her baby was delivered swiftly, but doctors soon discovered that Gould’s heart was failing.
Cardiologist Dr. Amer Sayed was called to evaluate her condition. He found that her ejection fraction, a key measure of heart function, had plummeted to just 13%, significantly below the normal range of 55% to 70%. Dr. Sayed faced a critical decision: to either implant an Impella pump to help her heart recover or to place her on the heart transplant waiting list. He opted for the pump, inserting it through her femoral artery. Gould spent the next two days in a coma on a ventilator in the intensive care unit, but gradually, her health began to improve.
Upon regaining consciousness, Gould was overjoyed to see her husband and newborn son, though she was initially unaware of the serious nature of her condition. “I thought maybe I hemorrhaged during the C-section or something,” she explained, noting that it took time for the medical staff to clarify that she had suffered from heart failure.
Gould had been diagnosed with peripartum cardiomyopathy, a rare condition that can cause the heart to weaken during late pregnancy or shortly after childbirth. According to Dr. Adam Small from NYU Langone’s Adult Congenital Heart Disease Program, this condition affects about 1 in every 5,000 pregnancies. The unpredictability of its onset adds to its severity, with factors like age and previous pregnancies increasing risk.
Patients may show warning signs such as shortness of breath, and Gould’s feelings of dread could have been related to fluid buildup in her lungs or a drop in blood pressure, Dr. Small noted. While not all cases of peripartum cardiomyopathy necessitate a C-section, it is performed when there is concern that labor might stress the heart too much. Stabilizing the patient and allowing the heart to rest, as achieved with the Impella pump, is crucial for recovery.
Following nine days in the ICU, Gould faced a challenging return home. Not only did she have to recover from major surgery, but she and her husband also had to adapt to life with a newborn. Initially hesitant to delve into the details of her medical crisis, Gould eventually sought out information and began to understand the gravity of her experience. “This was the most traumatic night of a lot of people’s lives. It’s been hard,” she reflected. “Learning about it, it doesn’t feel like it happened to me.”
Today, Gould’s heart function has returned to normal, though she will continue to take medication and monitor her health with a cardiologist for the foreseeable future. However, she has been advised against having more children, as subsequent pregnancies would pose significant risks. “The fact that I went from where I was to where I am now is pretty miraculous,” she stated.
Despite the difficulties, Gould cherishes her role as a mother. Her son is now a happy, healthy 1-year-old who enjoys swimming lessons and has started sleeping through the night. Recently, she shared her story at a medical conference in Phoenix, proudly accompanied by her son. She has also received invitations to visit Impella’s headquarters in Boston and plans a family trip to Glacier National Park in Montana.
“I get this chance to be his mom and be a wife and to still be here and do things. It’s just the little things, like going on bike rides this summer now that he’s big enough to sit in the bike carrier,” Gould expressed. “Every day feels like a gift. I know that’s silly, people say it a lot, but every morning kind of feels like Christmas.”
