Peripartum cardiomyopathy

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Heart, front view

Heart, section through the middle

Peripartum cardiomyopathy

Cardiomyopathy - peripartum

Hospitalization may be required until acute symptoms subside. Because heart dysfunction is usually reversible, and the patients are usually young, everything possible will be done to ensure survival.

This may include taking extreme measures such as using an aortic counterpulsation balloon (balloon pump), immunosuppressive therapy (such as that used to treat cancer or prevent rejection of a transplanted organ), or a heart transplant.

For most women, however, treatment focuses simply on relieving the symptoms. Some symptoms resolve on their own without treatment.

Medications include diuretics (water pills) to remove excess fluid, vasodilators called ACE-inhibitors to improve blood flow from the heart, digitalis to strengthen the heart's pumping ability, and low-dose beta-blockers. A low-salt diet may be recommended. Fluid may be restricted in some cases. Activities, including nursing the baby, may be limited when symptoms develop.

Daily weighing may be recommended. A weight gain of 3 or 4 pounds or more over 1 or 2 days may indicate fluid accumulation.

Smoking and drinking alcohol must be stopped, as these habits may make the symptoms worse.

There are several possible outcomes in peripartum cardiomyopathy. Some women remain stable for long periods, while others deteriorate gradually. Some deteriorate rapidly and may be candidates for a heart transplant. The death rate may be as high as 25-50%.

For women whose hearts returns to normal size after the baby is born, the prognosis is good. If the heart remains enlarged, future pregnancies may result in heart failure. It is not known how to predict who will recover and who will develop severe heart failure.

Women who develop peripartum cardiomyopathy are at high risk of developing the same problem with future progenancies and should discuss contraception with their physician.

• Congestive heart failure
• Cardiac arrhythmias, some of which may be deadly
• Pulmonary emboli (blood clots in the lungs)

• If you are currently pregnant or recently delivered a baby and think you may have signs that cardiomyopathy may be developing
• You develop chest pain, palpitations, faintness, or other new or unexplained symptoms

Review Date: 11/06/2006
Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.