Peripartum cardiomyopathy: A condition physicians should be aware of

摘要

Peripartum cardiomyopathy (PPCM) is a poorly characterised, rare form of cardiomyopathy. The aetiology of PPCM is unknown, but viral, autoimmune, and idiopathic causes may contribute 1 . R isk factors include multiparity, age > 30 years, multiple pregnancies, obesity, hypertension, and toxaemia. Th e presentation is similar to other forms of congestive heart failure. Signs and symptoms of PPCM resemble systolic heart failure, and it is diagnosed by exclusion. The diagnosis of PPCM should not be considered until other causes of cardiac dysfunction are ruled-out. Echocardiography is central to diagnosis. An echocardiogram t ypically reveals an ejection fraction of 2.7 cm/ m 2 of body surface area 2 . Treatment consists of diuretics, vasodilators, digoxin. Patients with PPCM are at high risk of thromboembolism, and therefore anticoagulation therapy should be considered. The prognosis is variable, ranging from complete recovery to worsening heart failure requiring cardiac transplantation, or death. Future pregnancies are often discouraged because of the high mortality rate and risk of recurrence. Prognosis is related to recovery of ventricular function 3,4,5 .