Peripartum cardiomyopathy: a review
Corina Iorgoveanu1, Ahmed Zaghloul1, Mahi Ashwath2
1Division of Cardiovascular Medicine, University of Iowa Hospitals and Clinics, University of Iowa Health Care, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
Heart Failure Reviews
|June 17, 2021
Summary
Peripartum cardiomyopathy is a rare heart failure affecting women late in pregnancy or postpartum. Early diagnosis and careful management are crucial for maternal and fetal outcomes, as recovery varies.
Area of Science:
- Cardiology
- Obstetrics
- Maternal-Fetal Medicine
Background:
- Peripartum cardiomyopathy (PPCM) is an idiopathic systolic heart failure.
- It occurs late in pregnancy or postpartum without a clear cause.
- Higher incidence observed in women of African ancestry, multiparous, hypertensive, or older maternal age.
Purpose of the Study:
- To summarize the current understanding of peripartum cardiomyopathy.
- To highlight diagnostic challenges and management strategies.
- To discuss outcomes and areas for future research.
Main Methods:
- Review of existing literature on peripartum cardiomyopathy.
- Analysis of diagnostic criteria, focusing on echocardiography.
- Examination of current management guidelines and treatment considerations for fetal safety.
Main Results:
- Delayed diagnosis is common due to symptom overlap with normal pregnancy.
- Echocardiography is central to diagnosing decreased myocardial function.
- Management follows general non-ischemic cardiomyopathy guidelines with specific attention to fetal safety.
Conclusions:
- Outcomes for peripartum cardiomyopathy range from full recovery to persistent heart failure or death.
- Relapse rates are high in subsequent pregnancies, particularly with incomplete recovery.
- Further research is needed on etiology, experimental treatments, prognosis, and treatment duration.
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