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Peripartum Cardiomyopathy

  • Lee Anne Stratton
  • Soidjon Khodjaev
  • Srinivas MuraliEmail author
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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.

Keywords

Cardiomyopathy Pregnancy Heart failure Left ventricular function Mechanical circulatory support Cardiac transplantation Left ventricular thrombus 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Lee Anne Stratton
    • 1
  • Soidjon Khodjaev
    • 2
  • Srinivas Murali
    • 2
    Email author
  1. 1.Critical Care MedicineUniversity of Pittsburgh Medical CenterPittsburghUSA
  2. 2.Cardiovascular InstituteAllegheny Health NetworkPittsburghUSA

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