Poor Outcomes in Poor Patients?

Bauersachs, Johann

doi:10.1001/jamacardio.2017.3605

Cited by 13 publications

(3 citation statements)

References 10 publications

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“…The course of the disease ranges widely from milder forms with only slight and unspecific symptoms to severe forms with life-threatening cardiogenic shock [7, 10, 19]. Physicians are often faced with supposedly healthy women toward the end of their pregnancy or after delivery who complain of unspecific symptoms such as general discomfort, fatigue, and peripheral edema.…”

Section: Signs and Symptomsmentioning

confidence: 99%

Peripartum cardiomyopathy

Koenig

Hilfiker‐Kleiner

Bauersachs

2018

Herz

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Peripartum cardiomyopathy (PPCM) is a rare and potentially life-threatening disease that occurs toward the end of pregnancy or in the months following delivery in previously heart-healthy women. The incidence varies widely depending on geographical region and ethnic background, with an estimated number of 1 in 1000–1500 pregnancies in Germany. The course of the disease ranges from mild forms with minor symptoms to severe forms with acute heart failure and cardiogenic shock. The understanding of the etiology of PPCM has evolved in recent years. An oxidative stress-mediated cleaved 16-kDa fragment of the nursing hormone prolactin is thought to damage endothelial cells and cardiomyocytes. Bromocriptine, a dopamine-receptor agonist, effectively blocks prolactin release from the pituitary gland. In addition to standard heart failure therapy, this disease-specific treatment reduces morbidity and mortality in PPCM patients. This review summarizes the current knowledge on PPCM and the disease-specific treatment options.

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Section: Signs and Symptomsmentioning

confidence: 99%

Peripartum cardiomyopathy

Koenig

Hilfiker‐Kleiner

Bauersachs

2018

Herz

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“…7 With access to health care being a significant factor preventing care, African American women appear to have a poorer prognosis compared to women of other races. [7][8][9][10] Therefore, the literature recommends that early recognition and diagnosis of PPCM is key to increasing the chance of survival and recovery. [11][12][13][14] As a result of these recommendations, US cardiologist, Dr. James D. Fett developed and validated a self-test instrument to aid women to distinguish the signs and symptoms of PPCM from that of a normal pregnancy.…”

Section: Introductionmentioning

confidence: 99%

“…7 With access to health care being a significant factor preventing care, African American women appear to have a poorer prognosis compared to women of other races. 7–10 Therefore, the literature recommends that early recognition and diagnosis of PPCM is key to increasing the chance of survival and recovery. 11–14…”

Section: Introductionmentioning

confidence: 99%

An Adapted Self-screening Tool for Peripartum Cardiomyopathy in Haiti

René¹,

Faustin²,

Bonhomme

et al. 2023

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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Background: Peripartum cardiomyopathy (PPCM) is considered rare in the United States; however, the literature notes that the disease has a higher prevalence in developing countries such as Haiti. Dr. James D. Fett, a US cardiologist, developed and validated a self-assessment measure for PPCM in the United States to aid women to easily differentiate the signs and symptoms of heart failure from those related to a normal pregnancy. Although this instrument was validated, it lacks the adaptation necessary to account for the language, culture, and education of the Haitian population. Objective: The aim of this study was to translate and culturally adapt the Fett PPCM self-assessment measure for use among a Haitian Creole speaking population. Methods: A preliminary Haitian Creole direct translation was developed from the original English Fett self-test. A total of four focus groups with medical professionals and 16 cognitive interviews with members of a community advisory board were conducted to refine the preliminary Haitian Creole translation and adaptation. Results: The adaptation focused on incorporating cues that would be tangible and connected to the reality of the Haitian population while maintaining the intended meaning of the original Fett measure. Conclusions:The final adaptation provides an instrument suitable for administration by auxiliary health providers and community health workers to help patients distinguish symptoms of heart failure from symptoms related to normal pregnancy and further quantify the severity of signs and symptoms that might be indicative of heart failure.

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Anticoagulation in cardiomyopathy: unravelling the hidden threat and challenging the threat individually

et al. 2021

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Cardiomyopathy comprises a heterogeneous group of myocardial abnormalities, structural or functional in nature, in the absence of coronary artery disease and other abnormal loading conditions. These myocardial pathologies can result in premature death or disability from progressive heart failure, arrhythmia, stroke, or other embolic events. The European Cardiomyopathy Registry reports a high stroke risk in cardiomyopathy patients ranging from 2.1% to 4.5%, as well as high prevalence of atrial fibrillation ranging from 14.0% to 48.5%. There is a growing interest in evaluating the risk of thromboembolism depending on the type of cardiomyopathy, as well as if anticoagulation is indicated in patients with cardiomyopathy without atrial fibrillation. Data available do not unequivocally support anticoagulation therapy in all of these patients; the management of these patients remains challenging. Many published reports pertaining to the risk of thromboembolism and consecutive treatment strategies mainly focus on single cardiomyopathy subtype. We summarize essential pathophysiological knowledge and review current literature associated with thromboembolism in various cardiomyopathy subtypes, providing recommendations for the diagnostic evaluation as well as clinical management strategies in this field. Certain cardiomyopathy subtypes require anticoagulation independent of atrial fibrillation or CHA2DS2‐VASc score. Despite the scarcity of evidence regarding the choice of anticoagulation regimen (vitamin K antagonist vs. non‐vitamin K oral anticoagulants) in cardiomyopathy, it is discussed and reviewed in this article. Each patient should receive a tailored strategy based on thorough clinical evaluation, published evidence, and clinical experience, due to the current recommendations mostly developed on small‐sample studies or empirical evidence. The future research priorities in this area are also addressed in this article.

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Poor Outcomes in Poor Patients?

Cited by 13 publications

References 10 publications

Peripartum cardiomyopathy

Peripartum cardiomyopathy

An Adapted Self-screening Tool for Peripartum Cardiomyopathy in Haiti

Anticoagulation in cardiomyopathy: unravelling the hidden threat and challenging the threat individually

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