Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within the final month of pregnancy or within 5 months after delivery.
Cardiomyopathy – peripartum
Causes, incidence, and risk factors
Peripartum cardiomyopathy is a form of
In the United States, peripartum cardiomyopathy complicates 1 in every 1,300 – 4,000 deliveries. It may occur in childbearing women of any age, but it is most common after age 30.
Risk factors include
- Feeling of racing heart or skipping beats (
- Increased night-time urination (
nocturia) Shortness of breathwith activity and when laying flat Swellingof the ankles
Signs and tests
During a physical examination, the physician will look for signs of fluid in the lungs by touching and tapping with the fingers. Listening to the chest with a stethoscope will reveal lung crackles, a rapid heart rate, or abnormal heart sounds.
The liver may be enlarged and neck veins may be swollen. Blood pressure may be low or may drop when the patient stands up.
Heart enlargement, congestion of the lungs or the veins in the lungs, decreased cardiac output, decreased movement or functioning of the heart, or
Chest x-ray Chest CT scan Coronary angiography Echocardiogram Nuclear heart scan
The woman may need to stay in the hospital until
Because the heart dysfunction is usually reversible, and the women are usually young, everything possible will be done to ensure survival.
This may include taking extreme measures such as:
Use of a balloon heart pump (aortic counterpulsation balloon)
Immunosuppressive therapy (such as medicines used to treat cancer or prevent rejection of a transplanted organ)
Heart transplantif severe congestive heart failure persists
For most women, however, treatment focuses simply on relieving the symptoms. Some symptoms resolve on their own without treatment.
Digitalis to strengthen the heart’s pumping ability
Diuretics (water pills) to remove excess fluid
A low-salt diet may be recommended. Fluid may be restricted in some cases. Activities, including nursing the baby, may be limited when symptoms develop.
Daily weighing may be recommended. A weight gain of 3 or 4 pounds or more over 1 or 2 days may be a sign of fluid buildup.
Women who smoke and drink alcohol will be advised to stop, since these habits may make the symptoms worse.
There are several possible outcomes in peripartum cardiomyopathy. Some women remain stable for long periods, while others get worse slowly.
Others get worse very quickly and may be candidates for a heart transplant. The death rate may be as high as 25 – 50%.
The outlook is good for women whose hearts returns to normal size after the baby is born. If the heart remains enlarged, future pregnancies may result in heart failure. It is not known how to predict who will recover and who will develop severe heart failure.
Women who develop peripartum cardiomyopathy are at high risk of developing the same problem with future pregnancies and should discuss contraception with their physician.
arrhythmias(can be deadly) Congestive heart failure Pulmonary emboli(blood clots in the lungs)
Calling your health care provider
Call your health care provider if you are currently pregnant or have recently delivered a baby and think you may have signs of cardiomyopathy.
Also seek medical attention if you develop chest pain, palpitations, faintness, or other new or unexplained symptoms.
Eat a well-balanced, nutritious diet, exercise to increase