Reviewed By: Pramod Kerkar, MD, FFARCSI

Peripartum cardiomyopathy or postpartum cardiomyopathy is a form of heart failure that occurs in the last month of pregnancy or exists for five months post-delivery. Peripartum cardiomyopathy affects the heart muscle, which causes sudden death.

Peripartum cardiomyopathy occurs in the dilated form where the heart chambers enlarge, and the muscle of the heart becomes weak. Due to the situation, there is a reduction in the percentage of the blood pumped by the heart. As the heart is pumping less blood, it is no longer in a position to meet the requirement of the body. Such a scenario affects the functionality of the organs, especially lungs, liver, and the nervous system.

The Peripartum Cardiomyopathy Mortality Rate

The Peripartum Cardiomyopathy Mortality Rate

Peripartum cardiomyopathy, found in women, is a rare scenario. However, those diagnosed with the condition possess only 50% chances to recover the cardiac functioning. Therefore, it is essential for obstetricians to monitor the health condition of the patient thoroughly. Additionally, one should suspect the diagnosis of the patient belongs to the African-American ethnicity. Evaluating the state will be helpful with the use of echocardiogram, which helps in assessing the left ventricle systolic function.

The ratio of the occurrence of Peripartum cardiomyopathy is rare. About 1500 women develop the disease every year in the United States alone. In other countries, the phenomenon can be standard due to its relation and differences in diet, medical conditions, genetics, and lifestyle.

Diagnosing Peripartum Cardiomyopathy

Diagnosing Peripartum cardiomyopathy is a tough task because it mimics the symptoms of heart failure. In addition, it simulates signs of trimester pregnancy, which includes swelling in legs, feet, and shortness of breath. In extreme cases, one can notice severe conditions such as shortness of the breath, and extensive swelling in feet or legs after delivery.

During the physical examination procedure, an obstetrician will look for symptoms of accumulation of fluid in the lungs. The doctor will listen to the lung crackles, abnormal heart sounds, and rapid heart rate with the help of a stethoscope. With the help of an echocardiogram, the doctor can confirm the presence of cardiomyopathy, as this test displays the reduced functioning of the heart.

When to Diagnose Peripartum Cardiomyopathy?

It is necessary for an individual to meet the following three criteria to undergo diagnosis procedure to confirm the presence of Peripartum cardiomyopathy.

  • Occurrence of heart failure in the last month of pregnancy or within five months after delivery
  • Reduction in the heart pumping with ejection fraction less than 45%
  • When there is no other cause for the occurrence of heart failure with reduced ejection fraction.

Laboratory assessment is also part of the standard evaluation. It includes tests to assess the functionality of kidney, thyroid glands, and liver. Additionally, it includes evaluation of electrolytes, sodium, potassium, and a complete blood picture to find out any presence of infection.

Symptoms of Peripartum Cardiomyopathy

The following are the symptoms displayed by an individual suffering from Peripartum cardiomyopathy:

  • Fatigue
  • Increased palpitations
  • Excess urination during nighttime
  • Shortness of breath
  • Swelling of the ankles
  • Swelling of the neck veins
  • Low blood pressure.

Classes of Severity

New York Heart Association developed classification based on the severity of the symptoms. These are:

  • Class I - Peripartum cardiomyopathy with no symptoms.
  • Class II - Symptoms with extreme exertion or mild symptoms on function.
  • Class III - Symptoms with negligible exertion.
  • Class IV - Symptoms are at rest.

Causes

Risk factors include:

  • Obesity
  • Smoking
  • Alcoholism
  • Poor nourishment
  • Multiple pregnancies
  • History of cardiac disorders.

With careful diagnosis and treatment, it is possible to overcome the situation with ease and prevent unforeseen circumstances such as sudden death or fetal loss.

Also Read:

Pramod Kerkar

Written, Edited or Reviewed By:

, MD,FFARCSI

Pain Assist Inc.

Last Modified On: October 20, 2018

This article does not provide medical advice. See disclaimer

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