title: Peripartum cardiomyopathy.
abstract: OBJECTIVE
  To determine the clinical and echocardiographic profiles of women with peripartum cardiomyopathy and ascertain the natural course of the disease.
  
  
  METHODS
  Fifty-six women with peripartum cardiomyopathy were followed up for a mean period of 6.1 years and their clinical and echocardiographic profiles were studied as well as their outcomes.
  
  
  RESULTS
  The mean+/-SD age at presentation was 31+/-5 years and mean parity was 2.6+/-1. Of the 56 patients, 18 (32.1%) had NYHA Class II, 24 (42.9%) had NYHA Class III, and 14 (25%) had NYHA Class IV symptoms, and 21 (37.5%) and 35 (62.5%), respectively, presented with features of heart failure during pregnancy and the postpartum. During follow-up, the left ventricular ejection fraction improved from 31%+/-7.2% to 43%+/-8% (P</=0.05). Nine patients (16.1%) became pregnant, with a mortality of 55.5% during pregnancy and 23.2% during follow-up.
  
  
  CONCLUSIONS
  Women with peripartum cardiomyopathy present with severe left ventricular dysfunction late in the pregnancy or early in the puerperium. A considerable number of women still die from this condition despite the use of angiotensin-converting enzyme inhibitors and beta-blockers. A subsequent pregnancy carries a very high risk of mortality.
authors.affiliation: Department of Cardiology, SCB Medical College, Cuttack, Orissa, India.
authors.forename: T K
authors.initials: TK
authors.lastname: Mishra
authors.forename: S
authors.initials: S
authors.lastname: Swain
authors.forename: S N
authors.initials: SN
authors.lastname: Routray
mesh_terms: D000328:Adult; D017668:Age of Onset; D009202:Cardiomyopathies / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D006333:Heart Failure; D006801:Humans; D007194:India; D009026:Mortality; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies; D018487:Ventricular Dysfunction, Left