Difference between revisions of "Peripartum cardiomyopathy"

(Evaluation)
Line 2: Line 2:
 
*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
*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
 
  
==Evaluation==
+
==Clinical Features==
*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%
 
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
Line 25: Line 15:
 
{{Postpartum emergencies DDX}}
 
{{Postpartum emergencies DDX}}
  
==Work-Up==
+
==Evaluation==
#ECG
+
===Workup===
#[[CXR]]
+
*[ECG]]
#CBC
+
*[[CXR]]
#Chemistry
+
*CBC
#TSH
+
*Chemistry
#TTE
+
*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

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

Cardiomyopathy

3rd Trimester/Postpartum Emergencies

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

  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.