title: Cardiomyopathy in pregnancy.
abstract: Cardiomyopathy during pregnancy is uncommon but potentially catastrophic to maternal health, accounting for up to 11% of maternal deaths. Peripartum cardiomyopathy is diagnosed in women without a history of heart disease 1 month before delivery or within 5 months postpartum. About half of all women will have full myocardial recovery within 6 months of diagnosis, but complications such as severe heart failure or death are not rare. African-American women have higher rates of diagnosis and adverse events. Women with preexisting cardiomyopathy, such as dilated or hypertrophic cardiomyopathy, followed closely during pregnancy often tolerate pregnancy and delivery. Risk factors for adverse outcomes include functional status at baseline, severity of systolic dysfunction or outflow tract gradient, or history of prior cardiac event, such as arrhythmia or stroke. The level of brain natriuretic peptide (BNP) can be used to risk stratify women for adverse events. Pregnant women with cardiomyopathy should be followed closely by a multidisciplinary team comprised of nurses, obstetricians, neonatologists, cardiologists, anesthesiologists, and cardiac surgeons.
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Lewey
authors.affiliation: Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY. Electronic address: jhh28@columbia.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Haythe
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D000075202:Contraindications; D004077:Digoxin / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008423:Maternal Age; D008428:Maternal Mortality; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011379:Prognosis; D012307:Risk Factors; D013148:Spironolactone / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D004232:Diuretics; D013148:Spironolactone; D004077:Digoxin
keywords: Cardiomyopathy; Heart failure; Peripartum; Pregnancy