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Peripartum Cardiomyopathy

  • Chizuko Aoki-KamiyaEmail author
Chapter

Abstract

Peripartum cardiomyopathy (PPCM) is a specific cardiomyopathy in which heart failure develops during pregnancy or in the postpartum period in women without a history of heart disease, and reduced myocardial contraction is found on examination. The frequency of this condition is low in routine medical practice, but it should be included in differential diagnosis for pregnant and postpartum women who complain of dyspnea and excessive edema because it may lead to maternal death in severe cases. Advanced age, grand multipara, multiple conception, hypertensive disorders in pregnancy (HDP), and use of tocolytic agents are known risk factors. Especially, HDP is the strongest risk factor and complicates in about 40% of PPCM patients. A Japanese survey found that PPCM patients with HDP tended to have better long-term outcomes than those without. In contrast, PPCM patients with truncating variants associated with dilated cardiomyopathy (DCM) tended to have lower cardiac function in long-term than those without. Basic studies in animals and genetic analyses have recently been reported, and an association between vascular disorder such as HDP cardiomyopathy is currently attracting attention. Since “peripartum cardiomyopathy” is a diagnosis of exclusion, it indicates that PPCM is a group of heterogeneous conditions.

Keywords

Cardiomyopathy Heart failure Hypertensive disorders in pregnancy Antiangiogenic factors 

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Copyright information

© Springer Science+Business Media Singapore 2019

Authors and Affiliations

  1. 1.The Department of Perinatology and GynecologyNational Cerebral and Cardiovascular CenterSuitaJapan

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