Peripartum cardiomyopathy: Difference between revisions
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==Background== | ==Background== | ||
*Disease earlier than last month of pregnancy is likely the same process of HF | *Disease earlier than last month of pregnancy is likely the same process of HF | ||
*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 relapse in subsequent pregnancies | |||
**Many patients recover within 3 to 6 months of disease onset | |||
==Evaluation== | ==Evaluation== | ||
Revision as of 22:36, 7 October 2018
Background
- Disease earlier than last month of pregnancy is likely the same process of HF
- Prognosis[1]
- Mortality rate up to 10%
- High risk of relapse 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
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
Work-Up
- ECG
- CXR
- CBC
- Chemistry
- TSH
- TTE
Management
- Treat like usual heart failure (except avoid nitroprusside and ACEI)
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.