[Peripartum cardiomyopathy].
The peripartum cardiomyopathy is a rare form of dilated cardiomyopathy. Its etiology remains unclear and is likely multifactorial. The diagnosis is based on the association of clinical heart failure and systolic dysfunction assessed by echocardiography or magnetic resonance imaging. Diagnosis to rule out are myocardial infarction, myocarditis, inherited cardiomyopathy, history of treatment by anthracycline. Risk factors are advance maternal age (> 30), multiparity, twin pregnancy, african origin, obesity, pre-eclampsia, gestational hypertension, and prolonged tocolytic therapy. Treatment of acute phase is identical to usual treatment of acute systolic heart failure. Angiotensin converting enzyme inhibitor and VKA are contra indicated during pregnancy. After delivery, VKA treatment should be discussed in case of systolic function < 25 % because of higher risk of thrombus. Complete recovery of systolic function is observed in 50 % of the case. The mortality risk is low. Subsequent pregnancy should be discouraged, especially if systolic function did not recover.
Bouabdallaoui
Nadia
N
Pôle de cardiologie et des maladies vasculaires, CHRU Lille, F-59037 Lille Cedex, France.
de Groote
Pascal
P
Mouquet
Frédéric
F
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004232:Diuretics / Q000627:therapeutic use; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008279:Magnetic Resonance Imaging; D011181:Postnatal Care / Q000379:methods; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D011295:Prenatal Care / Q000379:methods; D011379:Prognosis; D011644:Puerperal Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D035583:Rare Diseases; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists; D002316:Cardiotonic Agents; D004232:Diuretics