Cardiomyopathy and pregnancy

Abstract

Cardiomyopathy is a group of disorders in which the heart muscle is structurally and functionally abnormal in the absence of other diseases that could cause observed myocardial abnormality. The most common cardiomyopathies are hypertrophic and dilated cardiomyopathy. Rare types are arrhythmogenic right ventricular, restrictive, Takotsubo and left ventricular non-compaction cardiomyopathies. This review of cardiomyopathies in pregnancy shows that peripartum cardiomyopathy is the most common cardiomyopathy in pregnancy. Peripartum cardiomyopathy develops most frequently in the month before or after partum, whereas dilated cardiomyopathy often is known already or develops in the second trimester. Mortality in peripartum cardiomyopathy varies from <2% to 50%. Few reports on dilated cardiomyopathy and pregnancy exist, with only a limited number of patients. Ventricular arrhythmias, heart failure, stroke and death are found in 39%–60% of high-risk patients. However, patients with modest left ventricular dysfunction and good functional class tolerated pregnancy well. Previous studies on >700 pregnancies in 500 women with hypertrophic cardiomyopathy showed that prognosis was generally good, even though three deaths were reported in high-risk patients. Complications include different types of supraventricular and ventricular arrhythmias, heart failure and ischaemic stroke. Recent studies on 200 pregnancies in 100 women with arrhythmogenic right ventricular cardiomyopathy have reported symptoms, including heart failure in 18%–33% of pregnancies. Ventricular tachycardia was found in 0%–33% of patients and syncope in one patient. Information on rare cardiomyopathies is sparse and only presented in case reports. Close monitoring by multidisciplinary teams in referral centres that counsel patients before conception and follow them throughout gestation is recommended.

Twenty-eight Pregnant Women with Cardiac Diseases: A Review of Maternal and Fetal Outcomes in Pakistan

“…This was consistent with a previous regional study conducted in India [6] and Pakistan [7]. Cardiac disease is the most common non-obstetric maternal death [11].…”

“…Peripartum cardiomyopathy is more common generally in a month before or after partum, as opposed to dilated cardiomyopathy, which already presents itself by the second trimester. Mortality in peripartum cardiomyopathy varies from <2% to 50% [11]. Heart failure and arrhythmia are the most common complications associated with cardiomyopathy in pregnancy [11].…”

“…Mortality in peripartum cardiomyopathy varies from <2% to 50% [11]. Heart failure and arrhythmia are the most common complications associated with cardiomyopathy in pregnancy [11]. There are various risk factors, such as obesity, diabetes, hypertension, and stress, during pregnancy, which is responsible for the increase in cardiomyopathy.…”

Dilated cardiomyopathies and non-compaction cardiomyopathy

“…Initially described in 1849, this entity is still underdiagnosed. Peripartum cardiomyopathy is the most common form of cardiomyopathy in pregnancy and usually occurs in the last month before birth or in the first few months thereafter [27]. The defining criteria of PPCM are heart failure with reduced LVEF (<45%) and the absence of other causes for heart failure [28].…”

Mitochondrial Contact Sites in Inflammation-Induced Cardiovascular Disease

“…Cardiomyopathy is defined as a myocardial disorder in which the heart muscle is functionally and structurally abnormal ( McKenna et al, 2017 ). There are several different types of cardiomyopathies, and they can either be acquired, such as diabetic cardiomyopathy, or inherited, such as familial DCM ( McKenna et al, 2017 ; Schaufelberger, 2019 ). Diabetic cardiomyopathy, one of the complications caused by diabetes, is closely related to the increased incidence of HF and arrhythmia in diabetic individuals ( Boudina and Abel, 2007 ).…”