Peripartum Cardiomyopathy

What is peripartum cardiomyopathy?

Peripartum cardiomyopathy is a rare type of heart failure. Occurs during pregnancy or soon after birth. This condition weakens the heart muscle and causes the heart to enlarge. As a result, the heart cannot properly pump blood to the rest of the body.

According to the American Heart Association, this heart condition affects about 1,000 to 1,300 women in the United States each year. Women are usually diagnosed in the last month of pregnancy or within five months of giving birth.

What are the causes of peripartum cardiomyopathy?

Your heart pumps 50 percent more blood during pregnancy. This is because you need to transfer oxygen and vital nutrients to your growing baby. Peripartum cardiomyopathy does not have a definitive cause. However, doctors believe this occurs when the extra blood pumping is combined with other risk factors. This combination puts extra stress on the heart.

Who is at risk for peripartum cardiomyopathy?

Various risk factors can increase your chances of developing this condition, including:

  • obesity
  • hypertension
  • diabetes
  • personal history of heart disease, including myocarditis (heart muscle inflammation)
  • not enought feeding
  • to smoke
  • alcoholism
  • African-American descent
  • multiple pregnancies
  • be over 30
  • preterm birth medications

What are the symptoms of peripartum cardiomyopathy?

Peripartum cardiomyopathy symptoms are similar to heart failure symptoms. You can experience:

  • rapid heartbeat or palpitations
  • chest pain
  • overstrain
  • fatigue during physical activity
  • shortness of breath
  • swelling in the feet and ankles
  • increased urination at night

How is peripartum cardiomyopathy diagnosed?

Your doctor will review your symptoms and perform a physical exam. A device called a stethoscope may be used to help the doctor listen for crackling sounds in the lungs and abnormal sounds in the heart. Your doctor will also test your blood pressure. It may be lower than normal and fall significantly when you stand up.

Various imaging tests can measure your heart. These tests also determine the blood flow rate. Some of these imaging tests can also see potential lung damage. Tests may include:

  • x-ray of the entire chest
  • CT scan for detailed pictures of the heart
  • nuclear heart scan to show heart chambers
  • sound waves to create moving pictures of the heart (echocardiogram)

What are the treatment options for peripartum cardiomyopathy?

Women who develop this condition stay in the hospital until their symptoms are under control. And your doctor will recommend treatment based on the severity of your condition. Peripartum cardiomyopathy heart damage is irreversible. However, a damaged heart can still function for a long time, depending on the severity of the damage. The severity of the damage will also determine whether a heart transplant is needed.

The outlook for women diagnosed with peripartum cardiomyopathy is good for those whose hearts return to normal size after delivery. This happens between 30-50 percent of women. In all cases, 4 percent of patients require a heart transplant and 9 percent die as a result of the heart transplant procedure.

Doctors recommend a heart transplant or a balloon heart pump in severe cases. However, for most women, treatment involves managing and reducing symptoms.

Your doctor may prescribe the following medicines to control your symptoms:

  • beta-blockers: drugs that lower blood pressure and increase blood flow by blocking the adrenal hormone
  • digitalis: drugs that strengthen the heart to improve pumping and circulation
  • diuretics: medications that lower blood pressure by removing excess water and salt from the body

Women with this condition may need to follow a low-salt diet to manage their blood pressure. They should completely avoid alcohol and tobacco products. These products can make symptoms worse.

Peripartum cardiomyopathy can affect your health for the rest of your life, even after successful treatments. Perform regular checkups and take all medications as directed.

What are the complications associated with peripartum cardiomyopathy?

Severe complications include:

  • arrhythmia
  • blood clots, especially in the lungs
  • congestive heart failure
  • death

How can I prevent peripartum cardiomyopathy?

Certain lifestyle habits can reduce your risk. This is especially important for first-time mothers. Focus:

  • do regular exercise
  • eating a low-fat diet
  • avoiding smoking
  • avoiding alcohol

Women diagnosed with peripartum cardiomyopathy are at risk of developing the condition with future pregnancies. In these cases, women can take birth control to prevent pregnancy.

What is the long-term outlook?

The outlook for this condition depends on the severity of your condition and the time frame. Some women who develop the condition during pregnancy may have their hearts return to their normal size after delivery. For others, their condition may continue to worsen. In these cases, a heart transplant may be the best way to maintain longevity.

Resources:

Givertz MM. (2013). Peripartum cardiomyopathy. https://doi.org/10.1161/CIRCULATIONAHA.113.001851

Johnson-Coyle L. (2012). Peripartum cardiomyopathy: Review and apply guidelines.

Peripartum cardiomyopathy. (2016).

Peripartum cardiomyopathy (PPCM). (2015).

Radhakrishnan R, et al. (2009). Peripartum cardiomyopathy: Causes, diagnosis and treatment.

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