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Peripartum Cardiomyopathy

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Evidence-Based Critical Care

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Abstract

Peripartum cardiomyopathy (PPCM) is a rare form of non-ischemic dilated cardiomyopathy of unknown origin that afflicts previously healthy women of childbearing age in the last month of gestation or during the first 5 months postpartum. The incidence of PPCM is low, and there are identifiable risk factors. The clinical outcomes are variable, though generally better than other forms of dilated cardiomyopathy. Mortality ranges from 5–32% and is significantly higher in women who have more advanced disease at diagnosis. Over half of patients have improvement of ventricular function on medical treatment, though some develop progressive, severe heart failure and even sudden death. Survivors are at risk for recurrence during subsequent pregnancies and should be counseled against it unless there is complete recovery of cardiac function. Treatment of PPCM is the same as heart failure with reduced ejection fraction, and all patients should be managed using ACC/AHA guideline-based drug therapy on goal doses. Certain drugs are not recommended for patients in the antepartum and breastfeeding periods. Patients with severe heart failure may need intravenous inotropic, vasopressor or vasodilator therapy, including temporary and durable mechanical circulatory support and cardiac transplantation.

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Authors and Affiliations

  1. Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Lee Anne Stratton

  2. Cardiovascular Institute, Allegheny Health Network, Pittsburgh, PA, USA

    Soidjon Khodjaev & Srinivas Murali

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  1. Lee Anne Stratton
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  2. Soidjon Khodjaev
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Correspondence to Srinivas Murali .

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Editors and Affiliations

  1. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Robert C. Hyzy

  2. Division of Pulmonary and Critical Care, University of Michigan, Ann Arbor, MI, USA

    Jakob McSparron

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Stratton, L.A., Khodjaev, S., Murali, S. (2020). Peripartum Cardiomyopathy. In: Hyzy, R.C., McSparron, J. (eds) Evidence-Based Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-26710-0_97

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