Study of Peripartum Cardiomyopathy at a Tertiary Care Hospital

BACKGROUNDPeripartum cardiomyopathy is an uncommon form of life-threatening, but potentially treatable heart failure affecting women during peripartum period with devastating consequences.Often missed its early diagnosis and appropriate management can improve the outcome of such patients. OBJECTIVESTo study the clinical profile, electrocardiographic and echocardiographic changes in clinically proven cases of peripartum cardiomyopathy. SETTINGWomen in peripartum period admitted to the Departments of General Medicine and Obstetrics and Gynaecology at Karnataka Institute of Medical Sciences, Hubli. PARTICIPANTS24 patients, diagnosed to have PPCM, based on the inclusion and exclusion criteria, selected over a period of one and a half year. METHODSDetailed history clinical features and investigations including ECG and Echocardiogram of selected patients at presentation and follow-ups, up to six months were recorded in prestructured proforma and data analysed. RESULTSResults revealed to be 1 per 944 deliveries, mean age 29+5.4 years, mean parity 2.12+0.95.87.5% {21} of patients presented in post-partum and just 12.5% (3) in ante-partum period.All patients presented with dyspnoea.Major ECG finding was Sinus Tachycardia (79.16%) followed by normal QRS complex (75%) and Left Ventricular Hypertrophy (50%).Ejection fraction was universally reduced.The main complications were Pulmonary Oedema 11(45.83%),Cardiogenic Shock 33.3% (8).As regards to outcome, 25% (6) of the patients with delayed diagnosis and reduced LV function died within first week of admission, the remaining 75% (18) were discharged of which 83.3% (15) recovered completely, while 16.6% (3) among the discharged patients had residual Heart Failure at the end of 6 months.Major therapeutics used were routine drugs used in the treatment of heart failure. INTERPRETATION AND CONCLUSIONPeripartum Cardiomyopathy (PPCM) is a rare, potentially life-threatening, but treatable illness.Women presenting with Heart Failure during peripartum period should be evaluated for PPCM.Early detection and standard management of cardiac failure using a multidisciplinary approach started early carries a better prognosis.