Peripartum cardiomyopathy is an idiopathic cardiomyopathy presenting with heart failure late in pregnancy or postpartum, diagnosed via clinical presentation, imaging, and biopsy, and managed primarily medically.
Emphasizes medical management for peripartum cardiomyopathy; leaves open questions on etiology and targeted therapies.
Peripartum cardiomyopathy is a idiopathy cardiomyopathy associated with heart failure towards the end of pregnancy or in the postpartum period. Various mechanisms like myocarditis, autoimmune response to pregnancy, viral infections, selenium deficiency, oxidative stress and prolonged tocolysis have been proposed as the etiology. The most common presentation is acute heart failure occurring usually within a few weeks after delivery with patients developing exertional breathlessness, orthopnea and paroxysmal nocturnal dyspnea. Cardiac Magnetic Resonance Imaging is useful in accurate measurement of chamber volumes and global and segmental myocardial function. The gold standard test for diagnosis of peripartum cardiomyopathy is Endomyocardial biopsy with the histological Dallas criteria. Most of these postpartum patients are managed medically. The risk of peripartum cardiomyopathy increases with increasing parity and outcomes in subsequent pregnancies was poor.
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Suthakaran et al. (2020) studied this question.
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