title: [Peripartum cardiomyopathy].
abstract: The peripartum cardiomyopathy is a rare form of dilated cardiomyopathy resulting from alteration of angiogenesis toward the end of pregnancy. The diagnosis is based on the association of clinical heart failure and systolic dysfunction assessed by echocardiography or magnetic resonance imaging. Diagnoses to rule out are myocardial infarction, amniotic liquid embolism, myocarditis, inherited cardiomyopathy, and history of treatment by anthracycline. Risk factors are advance maternal age (>30), multiparity, twin pregnancy, African origin, obesity, preeclampsia, gestational hypertension, and prolonged tocolytic therapy. Treatment of acute phase is identical to usual treatment of acute systolic heart failure. After delivery, VKA treatment should be discussed in case of systolic function <25% because of higher risk of thrombus. A specific treatment by bromocriptine can be initiated on a case-by-case basis. Complete recovery of systolic function is observed in 50% of cases. The mortality risk is low. Subsequent pregnancy should be discouraged, especially if systolic function did not recover.
authors.affiliation: Polyclinique du Bois, soins intensifs et cardiologie, 59000 Lille, France; Institut pasteur de Lille, Inserm UMR 1011, 59000 Lille, France. Electronic address: frederic.mouquet@univ-lille2.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Mouquet
authors.affiliation: AP-HP, université Pierre-et-Marie-Curie, Paris VI, hôpital de la Pitié-Salpêtrière, département de chirurgie thoracique et cardovasculaire, 75013 Paris, France.
authors.forename: Nadia
authors.initials: N
authors.lastname: Bouabdallaoui
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D058725:Peripartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000628:therapy; D011644:Puerperal Disorders / Q000175:diagnosis* / Q000628:therapy; D012307:Risk Factors; D015145:Tocolysis / Q000009:adverse effects