Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy

Abstract

Peripartum cardiomyopathy (PPCM) is a cause of pregnancy-associated heart failure. It typically develops during the last month of, and up to 6 months after, pregnancy in women without known cardiovascular disease. The present position statement offers a state-of-the-art summary of what is known about risk factors for potential pathophysiological mechanisms, clinical presentation of, and diagnosis and management of PPCM. A high index of suspicion is required for the diagnosis, as shortness of breath and ankle swelling are common in the peripartum period. Peripartum cardiomyopathy is a distinct form of cardiomyopathy, associated with a high morbidity and mortality, but also with the possibility of full recovery. Oxidative stress and the generation of a cardiotoxic subfragment of prolactin may play key roles in the pathophysiology of PPCM. In this regard, pharmacological blockade of prolactin offers the possibility of a disease-specific therapy.--

Peripartum noncompaction cardiomyopaty:new diagnosed after pregnancy

“…Some of them are Myocarditis, Cardiotropic viral infections [8] Apoptosis and Inflammation [9], and an abnormal hemodynamic response [10]. The European Society of Cardiology defined peripartum cardiomyopathy is a form of dilated cardiomyopathy with signs of heart failure in the last month of pregnancy or within six months of delivery [11]. Increased blood volume and cardiac output may precipitate heart failure symptoms such as dyspnea, dizziness, pedal edema, and orthopnea during pregnancy [12].…”

Peripartum cardiomyopathy, what if your patient plans to reconceive?

“…PPCM is a heart failure syndrome confined to late pregnancy and the postpartum period 13. In mid‐to‐late pregnancy, cardiac output is maintained, primarily due to an increase in heart rate and a decrease in afterload.…”

A Pregnant Patient with Aortic Regurgitation and Symptoms of Acute Heart Failure Caused by Peripartum Cardiomyopathy: A Case Report

“…It is a diagnosis of exclusion when no other cause of heart failure is found. The LV may not be dilated, but the LVEF is nearly always reduced below 45% [6]. PPCM is rare but a major cause of maternal death, accounting for 4% -25% of cases [7] In this case, we initially ruled out PPCM because she had severe AR before pregnancy.…”