Difference between revisions of "Peripartum cardiomyopathy"

(Background)
(Background)
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==Background==
 
==Background==
*Disease earlier than last month of pregnancy is likely the same process of HF
+
*Uncommon cause of heart failure
 +
*Usually occurs in last month of pregnancy or first five months postpartum
 
*Prognosis<ref>Bhattacharyya A et Al. Peripartum Cardiomyopathy: A Review. Tex Heart Inst J. 2012; 39(1): 8–16.</ref>
 
*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%
 
**Mortality rate up to 10%
**High risk of relapse in subsequent pregnancies
+
**High risk of recurrence in subsequent pregnancies
 
**Many patients recover within 3 to 6 months of disease onset
 
**Many patients recover within 3 to 6 months of disease onset
  

Revision as of 19:31, 8 March 2019

Background

  • Uncommon cause of heart failure
  • Usually occurs in last month of pregnancy or first five months postpartum
  • 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

Evaluation

  • Presentation similar to typical CHF
  • 4 criteria needed to meet definition for PPCM:
    • Development of heart failure in last month of pregnancy or within 5mo of delivery
    • Absence of an identifiable cause for the heart failure
    • Absence of recognizable heart disease prior to the last month of pregnancy
    • LV systolic dysfunction, such as LVEF < 45%

Differential Diagnosis

  • Respiratory tract infection
  • PE
  • MI
  • Postpartum fluid overload

Cardiomyopathy

3rd Trimester/Postpartum Emergencies

Work-Up

  1. ECG
  2. CXR
  3. CBC
  4. Chemistry
  5. TSH
  6. TTE

Management

  • Treat like usual heart failure (except avoid nitroprusside and ACEI)

See Also

References

  1. 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.