title: Peripartum cardiomyopathy.
abstract: OBJECTIVE
  To provide a review of the cardiac and obstetrical literature regarding the development of peripartum cardiomyopathy and, in particular, to examine risk factors, incidence, diagnosis, prognosis, and evidence-based treatment modalities.
  
  
  METHODS
  An extensive review of the current literature.
  
  
  RESULTS
  Peripartum cardiomyopathy is a cardiomyopathy of unknown cause that occurs in pregnant females, most commonly in the early postpartum period. It shares many clinical characteristics with idiopathic dilated cardiomyopathy but occurs at a younger age and is associated with a better prognosis. Diagnosis is based upon the clinical presentation of congestive heart failure and objective evidence of left ventricular systolic dysfunction. Conventional pharmacologic therapy for congestive heart failure, such as diuretics, digoxin, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, and beta-adrenergic blockers, are routinely used and are quite effective. For those patients who remain refractory to conventional pharmacologic therapy, cardiac transplantation and mechanical circulatory support are viable options.
  
  
  CONCLUSIONS
  Mortality rates in peripartum cardiomyopathy have decreased, and this is most likely related to advances over the past 5 yrs in medical therapy for heart failure. Aggressive use of implantable defibrillators has significantly reduced the risk of sudden death in these patients. For >50% of peripartum cardiomyopathy patients, left ventricular function normalizes with pharmacologic therapy. However, subsequent pregnancies almost always are associated with recurrence of left ventricular systolic dysfunction.
authors.affiliation: University of Pittsburgh School of Medicine, Clinical Services of the Heart Failure Network, and Pulmonary Hypertension Program, Pittsburgh, PA, USA.
authors.forename: Srinivas
authors.initials: S
authors.lastname: Murali
authors.forename: Marie R
authors.initials: MR
authors.lastname: Baldisseri
mesh_terms: D009202:Cardiomyopathies / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003422:Critical Care; D017147:Defibrillators, Implantable; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*
chemical_list: D002317:Cardiovascular Agents