title: [Peripartum cardiomyopathy in young women].
abstract: Two women aged 26 and 41 were diagnosed with peripartum cardiomyopathy (PPCM). They presented with shortness of breath and oedematous ankles. The first woman presented in her 37th week of pregnancy. Her father had had dilated cardiomyopathy. A caesarean section was carried out. Her left ventricular function declined and she was therefore treated by means of an Impella heart pump and later, a left-ventricular assisting device. She eventually underwent urgent heart transplantation and recovered. The second woman presented 6 weeks after having given birth to twins. She was treated with a diuretic, an ACE inhibitor, a beta blocker and recovered. PPCM is a rare and potentially life-threatening form of dilated cardiomyopathy with left-ventricular systolic dysfunction that affects women in late pregnancy or in the early puerperium. Its pathogenesis is poorly understood. The generation of a cardiotoxic prolactin subfragment appears to play a key role in the pathophysiology. PPCM is difficult to diagnose as the initial complaints may be interpreted as the normal physiologic changes of pregnancy. In addition, prior definitions emphasising strict time windows, the lack of awareness and the rarity of the full-blown disease have sometimes resulted in the condition being overlooked and misdiagnosed.
authors: Universitair Medisch Centrum, afd. Cardiologie, Utrecht, The Netherlands. s.lok@umcutrecht.nl
authors: Sjoukje I
authors: SI
authors: Lok
authors: Pieter A F
authors: PA
authors: Doevendans
authors: Corinne
authors: C
authors: Klöpping
authors: J Hans
authors: JH
authors: Kirkels
authors: Jaap R
authors: JR
authors: Lahpor
authors: Nicolaas
authors: N
authors: de Jonge
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis*; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis*; D011256:Pregnancy Outcome