Peripartum cardiomyopathy: a comprehensive review.
Peripartum cardiomyopathy (PPCM) is a rare disorder in which left ventricular dysfunction and symptoms of heart failure occur in the peripartum period in previously healthy women. Incidence of PPCM ranges from 1 in 1300 to 1 in 15,000 pregnancies. The etiology of PPCM is unknown, but viral, autoimmune, and idiopathic causes may contribute. The diagnostic criteria are onset of heart failure in the last month of pregnancy or in first 5 months postpartum, absence of determinable cause for cardiac failure, and absence of a demonstrable heart disease before the last month of pregnancy. Risk factors for PPCM include advanced maternal age, multiparity, African race, twinning, gestational hypertension, and long-term tocolysis. The clinical presentation of patients with PPCM is similar to that of patients with dilated cardiomyopathy. Early diagnosis and initiation of treatment are essential to optimize pregnancy outcome. Treatment is similar to medical therapy for other forms of dilated cardiomyopathy. About half the patients of PPCM recover without complications. The prognosis is poor in patients with persistent cardiomyopathy. Persistence of disease after 6 months indicates irreversible cardiomyopathy and portends worse survival.
Abboud
John
J
Center for Heart and Vessel Preclinical Studies, Division of Cardiology, St John Hospital and Medical Center, Wayne State University, Detroit, MI 48236, USA.
Murad
Yahya
Y
Chen-Scarabelli
Carol
C
Saravolatz
Louis
L
Scarabelli
Tiziano M
TM
D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000188:drug therapy*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000188:drug therapy*; D011379:Prognosis; D011644:Puerperal Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
D002316:Cardiotonic Agents