Peripartum cardiomyopathy

Peripartum cardiomyopathy is cardiovascular disorder that is seen only in females in third trimester to 6 months post delivery. It is a diagnosis of exclusion. The syndrome is still seen in Nigeria more especially Northern Nigeria where the largest cohort of patients were described in the early 70s. The longest follow up (30-35) years of the syndrome was also done in Zaria, Northern Nigeria. The etiology of the syndrome is unknown but from different parts of the world clinicians have associated the syndrome to different risk factors. The authors did a Medline, AJOL and other search to review write ups on this syndrome. Of the 27 publications on the syndrome from Nigeria, 90% came from the Northern Nigeria. In Nigeria the syndrome was associated with the famous Wakan Jeko which composes of a triad of hot baths, ingestion of pap (kunun kanwa) which is made with lake salt that has high levels of sodium (Na + ). Other authors have associated it with hypertension, myocarditis, use of tocolytics and deficiency of trace elements like selenium. Recently the South Africans have also proposed the possibility by products of stress on Prolactin leading to cardiac damage/Peripartum cardiomyopathy has maternal and child health implications in Nigeria, sometimes it does lead to maternal mortality so also infant mortality. Patients have been reported to have developed recurrent Peripartum cardiac failure if they did not take heed to the advice regarding avoiding the wakan jeko. Some of these patients have gone on to develop hypertension and presented with hypertensive cardiac failure or cerebrovascular accident. Peripartum cardiomyopathy etiology is still an enigma. A coordinated national and international effort is required to do a comprehensive research on this syndrome to put to rest or uphold some of the theories regarding etiology.