Peripartum Cardiomyopathy

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  • Peripartum cardiomyopathy is idiopathic heart failure occurring in the absence of any determinable heart disease during the last month of pregnancy or the first 5 months postpartum.

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    Peripartum cardiomyopathy is idiopathic heart failure occurring in the absence of any determinable heart disease during the last month of pregnancy or the first 5 months postpartum.

    Diagnostic echocardiographic criteria include left ventricular ejection fraction <0.45, M-mode fractional shortening <30% and end-diastolic dimension >2.7 cm/m2. ECG, MRI, endomyocardial biopsy, and cardiac catheterisation aid in the diagnosis and management of peripartum cardiomyopathy.

    Treatment includes conventional pharmacologic heart failure therapies, principally diuretics, angiotensin-converting enzyme inhibitors, vasodilators, digoxin, beta-blockers and anticoagulants. Targeted therapies (such as intravenous immunoglobulin, pentoxifylline, and bromocriptine) have shown promise in small trials, but require further evaluation. Despite a mortality rate of up to 10% and a high risk of relapse in subsequent pregnancies, many patients with peripartum cardiomyopathy recover within 3 to 6 months of disease onset.

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