Peripartum Cardiomyopathy (PPCM): Epidemiological, Clinical, Therapeutic, Evolutionary and Prognostic Aspects at the Amirou Boubacar Diallo National Teaching Hospital in Niamey (HNABD)

Epidemiological, clinical, therapeutic, evolutionary and prognostic aspects of PPCM in the Internal Medicine and Cardiology department of the Amirou Boubacar Diallo National Hospital: Retrospective and prospective descriptive study about 64 cases.Introduction: PPCM is a heart failure secondary to left ventricular systolic dysfunction with LVEF <45% or a fraction of shortening <30%, Occurred towards the end of pregnancy or in the months following childbirth (mainly the month following the childbirth) without any other identifiable cardiac cause it is a worldwide disease whose epidemiology varies considerably with a multifactorial etiology.The true incidence or prevalence of PPCM in Africa and many other populations remains unknown.The objective of the study was to bring out the epidemiological, clinical, therapeutic, evolutionary and promostic aspects of PPCM.Methodology: This is a retrospective and prospective descriptive and analytical study on PPCM in the internal medicine and cardiology department of HNABD from January 1, 2017 to December 31, 2019 for the retrospective part and from January 1, 2020 as of December 31, 2020 for the prospective part.Results: The prevalence of PPCM was 8.68% for heart failure; 3.82% compared to all heart disease and 2.06% compared to all entries.The average age is 28.2 years with extremes of 15 and 5 years.The clinical presentation was essentially that of global heart failure in 81.3% of cases.The alteration of the ejection fraction of the left ventricle was found in all patients, ie 100% divided between moderate in none, moderate in 53.1% and severe in 46.9% of cases.The treatment of PPCM in our series is that of heart failure.Four therapeutic measures were the basis of symptomatic treatment in all hospitalized patients: diet and diet regimen in 100% of them and ACE inhibitors in 95.3%.B blockers were used in 73.4% of patients outside the acute phase of the disease.Anticoagulants were used in 27 of the patients, i.e. 42.1% Digoxin in 16patients or 25% and antiplatelet drugs in 54.7% of patients.SLGT2 Inhibitors was used in 32.8% (21 patients).Bromocriptine was used 9.4% of the time.Thromboembolic complications are the most frequent, namely EP in 10.9% of cases, DVT 4.7%.Only one case of arrhythmia was found.Like other complications of pneumonia, pleurisy and severe anemia have been found.The mortality rate 17.2% related to cardiogenic shock in 36.36% of cases.The prognostic factors found are Young age, primiparity, 7 out of 11 deceased patients were between 15 and 20 years old and had only one parity, i.e. 63.6%, with no statistically significant link with respectively (P=0.09) and (P=0.18).63 1% of deceased patients came from poor and underprivileged rural areas without any statistically significant link (P=0.66).81.8% of deceased patients had a low socioeconomic level, with no statistically significant association between SSE and death (P=0.21).Nine (9) of the eleven (11) deceased patients had a severe alteration of LVEF on admission, ie 81.8%, with a very significant link (P=0.005).Conclusion: Knowledge of the epidemiological aspects of PPCM is necessary for the optimization of patient care.SLGT2 Inhibitors and Bromocriptine seem effective in these cases.