Peripartum cardiomyopathy

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Heart, section through the middle

Heart, front view

Peripartum cardiomyopathy

Peripartum cardiomyopathy

Alternative Names:

Cardiomyopathy - peripartum
Treatment:

Hospitalization may be required until acute symptoms subside. Because the heart dysfunction is usually reversible, and because patients are usually young, all means necessary are applied to ensure survival.

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This may include extreme measures such as using an aortic counterpulsation balloon, the use of immunosuppressive therapy (i.e., the type of therapy used to treat cancer or to prevent rejection of transplanted organs), or a heart transplant.

For most women, however, treatment focuses simply on relieving the symptoms. Some women's symptoms resolve on their own (spontaneously).

Medications include diuretics (water pills) to remove excess fluid, vasodilators called ACE-inhibitors to improve cardiac outflow, digitalis to strengthen cardiac outflow, and low-dose beta-blockers. A low-salt diet may be recommended. Fluid may be restricted in some cases. Activity may be restricted when symptoms develop, including nursing the baby.

Daily weighing may be recommended. A weight gain of 3 or 4 pounds or more over 1 or 2 days may indicate fluid accumulation.

If you smoke or drink alcohol, stop. These habits may make the symptoms worse.

Expectations (prognosis):

There are several possibilities in peripartum cardiomyopathy. Some women remain stable for long periods, some deteriorate gradually, and some deteriorate rapidly and may be candidates for a heart transplant. The death rate may be as high as 25-50%.

In women whose heart returns to normal size after the postpartum period, the prognosis is good. In contrast, if the heart remains dilated (enlarged), future pregnancy may result in progression of the heart failure. It is not known how to predict who will recover and who will develop severe heart failure and need extreme measures.

Complications:

Congestive heart failure
Cardiac arrhythmias, including lethal arrhythmias
Pulmonary emboli

Calling your health care provider:

If you are currently or recently pregnant and symptoms indicate cardiomyopathy may be developing.
Chest pain, palpitations, faintness, or other new or unexplained symptoms develop.