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Peripartum cardiomyopathy: current knowledge and future directions
Melinda Davis1, Claire Duvernoy1
1Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, 1500 E Medical Center Drive, SPC 5853, Ann Arbor, MI 48109-5853, USA.
Abstract:
Peripartum cardiomyopathy is a form of heart failure occurring at the end of pregnancy or early in the postpartum period. Women may recover, have persistent cardiac dysfunction or suffer complications and death. Women who are African-American, older, hypertensive or have multiple gestation pregnancies have increased risk. Diagnosis and treatment may be delayed due to similarities between symptoms of normal pregnancy and heart failure. Echocardiography is essential for the diagnosis, and B-type natriuretic peptide can be helpful. Treatment for systolic heart failure must be adjusted during pregnancy, and anticoagulation may be indicated. Even after recovery, subsequent pregnancy confers substantial risk of worsening heart failure. Further investigations into the etiology, duration of treatment and risks for relapse are needed.
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