[Heart failure and pregnancy]

Heart failure is a chronic disease affecting approximately 2 % of the population. It is currently known to be a major cause of gestational morbi-mortality. Hemodynamic modifications during pregnancy can reveal, aggravate, or even generate heart failure. Peripartum cardiomyopathy (PPCM), a diagnosis of exclusion, is the main cause of de novo heart failure in parturient women. Differential diagnoses are numerous and include stress cardiomyopathy ("takotsubo" syndrome) and decompensation of preexisting cardiopathy (hypertrophic, dilated, restrictive arrhythmogenic, ischemic, valvular…). Identification of the cause of heart failure is mandatory in view of adapting treatment and follow-up. After several physiological reminders, we will successively consider the different clinical phenotypes of acute peripartum cardiomyopathy, and then provide indications on treatment and management.