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Considerations for specific cardiomyopathies during pregnancy

Madeline Abrams1, Ella Magun, Ersilia M DeFilippis

  • 1Center for Advanced Cardiac Care, Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA.

Current Opinion in Cardiology
|April 5, 2023
PubMed

Insights

Maternal cardiovascular disease, including cardiomyopathy, is a leading cause of pregnancy mortality. This review covers various cardiomyopathies during pregnancy, focusing on risk, management, and outcomes beyond peripartum cardiomyopathy.

Area of Science:

  • Cardiology
  • Maternal-Fetal Medicine
  • Cardiovascular Disease in Pregnancy

Background:

  • Maternal mortality in the US is rising, with cardiovascular disease as a primary driver.
  • Cardiomyopathy and heart failure are significant contributors to pregnancy-related deaths.
  • Peripartum cardiomyopathy is common, but other cardiomyopathies also pose risks during pregnancy.

Approach:

  • This review synthesizes current knowledge on various cardiomyopathies during pregnancy.
  • It examines recent studies on preconception risk, counseling, and pharmacologic management.
  • Focus is placed on maternal outcomes in dilated, hypertrophic, arrhythmogenic right ventricular, noncompaction, and chemotherapy-induced cardiomyopathies.

Key Points:

  • Cardiomyopathy in pregnancy increases the risk of adverse cardiovascular events, morbidity, and mortality.
  • Preconception counseling and risk stratification are crucial for optimizing maternal outcomes.
  • Management strategies and outcomes vary across different types of cardiomyopathies during pregnancy.

Conclusions:

  • Recognizing and managing diverse cardiomyopathies in pregnancy is essential for improving maternal health.
  • Further research is needed for less common cardiomyopathies to establish standardized recommendations.
  • Optimizing antepartum management requires a comprehensive understanding of these conditions.
Abstract

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