Peripartum Cardiomyopathy
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Definition
Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within the final month of pregnancy or within 5 months after delivery.
Alternative Names
Cardiomyopathy - peripartum
Causes, incidence, and risk factors
Cardiomyopathy occurs when there is damage to the heart. As a result, the heart muscle becomes weak and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.
Peripartum cardiomyopathy is a form of dilated cardiomyopathy in which no other cause of heart dysfunction (weakened heart) can be identified.
In the United States, peripartum cardiomyopathy complicates 1 in every 1,300 - 4,000 deliveries. It may occur in childbearing women of any age, but it is most common after age 30.
Risk factors include obesity, having a personal history of cardiac disorders such as myocarditis, use of certain medications, smoking, alcoholism, multiple pregnancies, being African American, and being malnourished.
Review Date: 5/4/2010
Reviewed By: Issam Mikati, MD, Associate Professor of Medicine. Feinberg School of Medicine, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Cardiomyopathy - peripartum
Symptoms
Signs and tests
During a physical examination, the physician will look for signs of fluid in the lungs by touching and tapping with the fingers. Listening to the chest with a stethoscope will reveal lung crackles, a rapid heart rate, or abnormal heart sounds.
The liver may be enlarged and neck veins may be swollen. Blood pressure may be low or may drop when the patient stands up.
Heart enlargement, congestion of the lungs or the veins in the lungs, decreased cardiac output, decreased movement or functioning of the heart, or heart failure may show on:
A heart biopsy may be helpful in determining an underlying cause of cardiomyopathy. Many cases of peripartum cardiomyopathy seem to be related to myocarditis, which can be confirmed by a heart biopsy.
Review Date: 5/4/2010
Reviewed By: Issam Mikati, MD, Associate Professor of Medicine. Feinberg School of Medicine, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Cardiomyopathy - peripartum
Treatment
The woman may need to stay in the hospital until acute symptoms subside.
Because the heart dysfunction is usually reversible, and the women are usually young, everything possible will be done to ensure survival.
This may include taking extreme measures such as:
For most women, however, treatment focuses simply on relieving the symptoms. Some symptoms resolve on their own without treatment.
Medications include:
A low-salt diet may be recommended. Fluid may be restricted in some cases. Activities, including nursing the baby, may be limited when symptoms develop.
Daily weighing may be recommended. A weight gain of 3 or 4 pounds or more over 1 or 2 days may be a sign of fluid buildup.
Women who smoke and drink alcohol will be advised to stop, since these habits may make the symptoms worse.
Expectations (prognosis)
There are several possible outcomes in peripartum cardiomyopathy. Some women remain stable for long periods, while others get worse slowly.
Others get worse very quickly and may be candidates for a heart transplant. The death rate may be as high as 25 - 50%.
The outlook is good for women whose hearts returns to normal size after the baby is born. If the heart remains enlarged, future pregnancies may result in heart failure. It is not known how to predict who will recover and who will develop severe heart failure.
Women who develop peripartum cardiomyopathy are at high risk of developing the same problem with future pregnancies and should discuss contraception with their physician.
Complications
Calling your health care provider
Call your health care provider if you are currently pregnant or have recently delivered a baby and think you may have signs of cardiomyopathy.
Also seek medical attention if you develop chest pain, palpitations, faintness, or other new or unexplained symptoms.
Review Date: 5/4/2010
Reviewed By: Issam Mikati, MD, Associate Professor of Medicine. Feinberg School of Medicine, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Alternative Names
Cardiomyopathy - peripartum
Prevention
Eat a well-balanced, nutritious diet, exercise to increase cardiovascular fitness, and avoid cigarettes and alcohol. Your doctor may advise you to avoid getting pregnant again if you have had heart failure during a previous pregnancy.
Review Date: 5/4/2010
Reviewed By: Issam Mikati, MD, Associate Professor of Medicine. Feinberg School of Medicine, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
Review Date: 5/4/2010
Reviewed By: Issam Mikati, MD, Associate Professor of Medicine. Feinberg School of Medicine, Northwestern University, Chicago, IL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.