Peripartum cardiomyopathy

The diagnosis of peripartum cardiomyopathy should be considered whenever women present with heart failure during the peripartum period. This cardiomyopathy is distinguished by rapid onset, occurrence in the peripartum period, and significant improvement in up to 50% of affected women. The cause and pathogenesis of this dilated cardiomyopathy remain unknown. Treatment is similar to medical therapy for other forms of dilated cardiomyopathy. Worsening of heart failure may require management in the ICU with support by vasodilators, inotropes, and ventricular assist devices. Patients with severe ventricular dysfunction are less likely to survive and recover normal cardiac function. Subsequent pregnancies may provoke a recurrence, even in patients who apparently recover.