Mother Develops a Serious Heart Condition After Childbirth, and Receives a Life-Changing Heart Transplant
In 2009, after the birth of her second child, Nafisha Moore started to develop severe shortness of breath. She was only 27 at the time, and assumed the breathing issues were due to springtime allergies and a possible flare-up of her asthma. When the breathlessness started to get worse, she paid a visit to her local Emergency Department (ED) to get asthma treatment. However, the doctors could not find anything wrong with her lungs. When they applied pressure to her abdomen, she explained that she had been experiencing discomfort for a number of days.
They ran further tests to see if there might be an issue with her heart. The tests confirmed a serious heart issue that would need further investigation. The ED team arranged for her immediate transfer to Mount Sinai Morningside.
Over the next five days, the cardiology team at Mount Sinai Morningside ran a series of tests and diagnosed postpartum cardiomyopathy. This is a rare form of heart failure where the heart muscle becomes weakened either during pregnancy or just after childbirth. An ultrasound revealed that her heart muscle had a severely reduced ejection fraction (the rate at which blood is pumped out with each heartbeat). A normal ejection fraction is above 55 percent; less than 35 percent is regarded as severe.
The cardiology team prescribed a combination of treatments to help strengthen the heart and to raise her ejection fraction percentage, as well as medication to control cholesterol and blood pressure. Her care was overseen by heart failure specialist, Marrick Kukin, MD (who has since retired) and Cathleen Varley, NP.
A weakening heart
By the following year, Nafisha’s condition worsened, and she needed a defibrillator to help prevent abnormal heart rhythms and regulate her heartbeat. The defibrillator helped, but her condition continued to deteriorate over time, with no real improvement in her ejection fraction percentage. In April 2023, Cathleen Varley referred her to Kiran Mahmood, MD, Assistant Professor of Medicine at the Icahn School of Medicine at Mount Sinai and a specialist in advanced heart failure and transplant cardiology.
“Cathleen has worked with me since 2009 and was very aware of my medical history,” Nafisha says. “She mentioned Dr. Mahmood and the work she has been doing for patient care and felt we would be a good match.”
Dr. Mahmood ran a series of tests, including a cardiopulmonary stress test, a right heart catheterization to measure the pressures in the heart, and another ultrasound of the heart. Nafisha also an assessment for transcatheter mitral valve repair (to repair damage to the mitral valve in the heart).
“Unfortunately, due to the anatomy of the heart, the transcatheter mitral valve repair was not a good option for Nafisha,” Dr. Mahmood says. “Over time, her symptoms worsened, and she reached out to me to let me know she was experiencing abdominal discomfort, bloating, and swelling in the legs. I was concerned that her abdominal symptoms were related to decreased blood flow from the heart and that it was time to evaluate her for a heart transplant.”
Candidate for a transplant
Nafisha then started the evaluation process for a heart transplant. In February 2024, she met with Anelechi Anyanwu, MD, Vice Chair and Professor of Cardiovascular Surgery at the Icahn School of Medicine at Mount Sinai and Surgical Director of Heart Transplantation.
“He went over what he saw in my records, all of the different heart assessments, the endoscopy, colonoscopy, the liver biopsy,” Nafisha says. “He said that I was a candidate for the transplant and that he was going to move forward with the approval.”
By this time, she was experiencing a host of physical issues related to her weakening heart. In addition to chronic breathlessness and fatigue, fluid was building up in her lungs and feet, and other organs were affected.
“I couldn't even walk a block or climb steps, I couldn't breathe or lie on my back,” Nafisha says. “I was very nauseous and losing a lot of weight, and I was having issues with my liver and heavy pain in my abdomen. Everything was just breaking down.”
Her condition became serious enough for her to be admitted to hospital on May 20 to await a heart transplant. She was told that a compatible heart was available for transplant on May 29 and underwent the transplant procedure on the same day. The procedure was performed by Dr. Anyanwu and his team, and took seven hours.
After the transplant, Nafisha felt better very quickly.
“I could see the improvement when I was in the ICU,” she says. “I was given occupational therapy and physical therapy, where they determine the distance you can walk before you need to rest. By my second or third day, I was doing six laps around the floor. Not a month before, I couldn't even walk a half a block, so it was an immediate change for me”
“I feel great now”
Nafisha was discharged from the hospital ten days after her procedure. To ensure that her body was not rejecting the new heart, she returned to the hospital for the next two months for regular biopsies, followed by ongoing monthly blood tests. Four months after the operation, Nafisha continued to build up her strength and to adjust to having a much healthier life.
“I feel great now. Sometimes I forget that I have this new heart—because I went 15 years of having restrictions. If I’m going up steps, I’ll rest in the middle and then ask myself, ‘Why are you resting? You feel fine.’ It’s like re-teaching myself how to live a normal life.”
Nafisha is very positive about the care she has received at Mount Sinai. “The level of comfort and attention that they have for you is unmatched. They treat you like you are their only patient, even though I know there are thousands of patients, and I think that is so important, because sometimes as a patient, you feel unseen. And patient care is their utmost priority. This applies to the simplest things like scheduling an appointment or refilling medication. Help is always there.”
Nafisha expressed profound gratitude to Dr. Mahmood and Dr. Anyanwu.
“Dr. Mahmood cares about more than your health physically,” Nafisha says. “She also takes in consideration your emotional and mental health. She is concerned about how you feel all around and how your family is doing as a support for you as well.
“When I first met Dr. Anyanwu, he really went through my whole track history and wanted to know truly what was going on with me. Now, every time I see him, he always says to me, ‘You never look like what's going on inside’. That's our little joke.”
Nafisha feels that her recovery is also due to her commitment to keeping fit and appreciating the second chance she has been given at life.
“My fight to live a long life started with finding out I had heart disease 15 years ago, when I had two young children and a whole life ahead of me. I believe I was granted this extension of life because I make an effort to live a healthy lifestyle—body, mind, and spirit. In addition, I attend all my appointments, take my medication, follow all recommendations and the most important part, I chose a hospital that cares for me as much as I do.”