Peripartum cardiomyopathy: Difference between revisions
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*Uncommon cause of heart failure | *Uncommon cause of heart failure | ||
*Usually occurs in last month of pregnancy or first five months postpartum | *Usually occurs in last month of pregnancy or first five months postpartum | ||
== | ==Clinical Features== | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 25: | Line 15: | ||
{{Postpartum emergencies DDX}} | {{Postpartum emergencies DDX}} | ||
== | ==Evaluation== | ||
===Workup=== | |||
*[ECG]] | |||
*[[CXR]] | |||
*CBC | |||
*Chemistry | |||
*TSH | |||
*TTE | |||
==Diagnosis== | |||
*Presentation similar to typical [[CHF]] | |||
*4 criteria needed to meet definition for PPCM: | |||
**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== | ==Management== | ||
*Treat like usual heart failure (except avoid nitroprusside and ACEI) | *Treat like usual heart failure (except avoid nitroprusside and ACEI) | ||
==Disposition== | |||
==Prognosis<ref>Bhattacharyya A et Al. Peripartum Cardiomyopathy: A Review. Tex Heart Inst J. 2012; 39(1): 8–16.</ref>== | |||
*Mortality rate up to 10% | |||
*High risk of recurrence in subsequent pregnancies | |||
*Many patients recover within 3 to 6 months of disease onset | |||
==See Also== | ==See Also== | ||
Revision as of 04:53, 2 April 2019
Background
- Uncommon cause of heart failure
- Usually occurs in last month of pregnancy or first five months postpartum
Clinical Features
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
- [ECG]]
- CXR
- CBC
- Chemistry
- TSH
- TTE
Diagnosis
- Presentation similar to typical CHF
- 4 criteria needed to meet definition for PPCM:
- 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
Prognosis[1]
- Mortality rate up to 10%
- High risk of recurrence in subsequent pregnancies
- Many patients recover within 3 to 6 months of disease onset
See Also
References
- ↑ Bhattacharyya A et Al. Peripartum Cardiomyopathy: A Review. Tex Heart Inst J. 2012; 39(1): 8–16.
- 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.