The Role of Ecg, Echo and CMR in Diagnosis and Prognosis of Peripartum Cardiomyopathy - A Death Threat in Young Women

Peripartum cardiomyopathy (PPCM) is a rare type of heart dysfunction characterized by acute impairment of cardiac contractility that occurs either shortly before or after delivery in women that weren’t previously diagnosed with cardiac disease. Particular attention should be paid to the fact that it is a considerable cause of late maternal morbidity and mortality and about 50% of the women affected regain complete function. Early diagnosis is crucial to start treatment and prevent deaths of young mothers. This narrative review focuses on imaging which is one of the most important parts of identifying this condition. It summarizes and provides analysis of various methods of imaging. The main opinions that we have in the diagnostic process are electrocardiography (ECG), echocardiography (ECHO) and cardiac magnetic resonance (CMR). Each of them has characteristic abnormalities in peripartum cardiomyopathy. Electrocardiography presents with sinus tachycardia, abnormal ST patterns, T-wave abnormalities and many others explained in the review. Echocardiography is characterized by in impaired systolic ejection fraction of the left ventricle, dilatation of chambers and reduced strains. Furthermore, it allows us to exclude different underlying causes of heart dysfunction. Besides echocardiography, cardiac magnetic resonance also helps us to conduct differential diagnosis. The changes we might see in resonance are correlating with echocardiographic findings. Additionally, we might access tissue structure like myocyte edema, extracellular volume, necrosis and fibrosis. Many of the reported findings are prognostically relevant in this disease and should be taken into consideration, as they may aid in differentiating women at risk of unfavorable outcomes.