Idiopathic Myocardiopathy of the Puerperium (Postpartal Heart Disease)

It should be clearly understood that no evidence was uncovered to indicate an unequivocal etiology for this uncommon disease. One is tempted to qualify "uncommon" in that it no longer connotes the same extreme degree of rarity that would appear from medical literature. Over the same period that these cases were collected an equal number were recognized but unavailable for study for various reasons. Unfortunately, the size of our series precludes statistical analysis. The apparent tendencies to hypercholesteremia, blood-group predilection, and increased incidence of abnormal hemoglobin types are in need of further exploration. One would be remiss not to note at this point that at least one report 20 related several instances of familial incidence of postpartal heart disease. We are more certain of the significance of malnutrition as a factor in the genesis of this syndrome, although we are unable to assign a precise role. Similarly, the deleterious effects on such patients of hypertension, pyelonephritis, and full-term pregnancy have impressed us, although we can make no judgment as to their frequency of occurrence. Probably, as so often happens, we are most certain of our single pre-investigatory premise that postpartal heart disease is a serious and pernicious syndrome, quite different from that described in most of the literature. That prolonged bed rest is not a panacea is obvious. It is of sufficient merit, however, to warrant use in all such patients, for periods up to 1 year at least.