Peripartum cardiomyopathy: Difference between revisions
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4 criteria needed to meet definition: | 4 criteria needed to meet definition:<ref>Elkayam U et al. Pregnancy-associated cardiomyopathy: clinical characteristics and a comparison between early and late presentation. Circulation. 2005 Apr 26; 111(16): 2050-5.</ref> | ||
#Development of heart failure in last month of pregnancy or within 5 month postpartum | #Development of heart failure in last month of pregnancy or within 5 month postpartum | ||
#No identifiable alternate cause of heart failure | #No identifiable alternate cause of heart failure | ||
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==References== | ==References== | ||
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[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:OBGYN]] | [[Category:OBGYN]] | ||
Revision as of 04:59, 2 April 2019
Background
- Uncommon cause of heart failure
Clinical Features
- Peripartum with presentation similar to typical CHF
- Usually occurs in last month of pregnancy or first five months postpartum
Differential Diagnosis
Cardiomyopathy
- Dilated cardiomyopathy
- Hypertrophic cardiomyopathy
- Restrictive cardiomyopathy
- Peripartum cardiomyopathy
- Takotsubo cardiomyopathy
- Arrhythmogenic right ventricular dysplasia
3rd Trimester/Postpartum Emergencies
- Acute fatty liver of pregnancy
- Amniotic fluid embolus
- Chorioamnionitis
- Eclampsia
- HELLP syndrome
- Mastitis
- Peripartum cardiomyopathy
- Postpartum endometritis (postpartum PID)
- Postpartum headache
- Postpartum hemorrhage
- Preeclampsia
- Resuscitative hysterotomy
- Retained products of conception
- Septic abortion
- Uterine rupture
Evaluation
Workup
Diagnosis
4 criteria needed to meet definition:[1]
- Development of heart failure in last month of pregnancy or within 5 month postpartum
- No identifiable alternate cause of heart failure
- No pre-existing heart disease
- LV ejection fraction < 45%
Management
- Treat like usual heart failure (except avoid nitroprusside and ACEI)
Disposition
- Admit
Prognosis[2]
- Mortality rate up to 10%
- High risk of recurrence in subsequent pregnancies
- Many patients recover within 3 to 6 months of disease onset