II. Definitions

  1. Postpartum Cardiomyopathy
    1. Left Ventricular Systolic Dysfunction onset in late pregnancy or first 5 months postpartum

III. Epidemiology

  1. Incidence: 1:1000 to 4000 live births
  2. Onset
    1. Typical: First week after delivery (up to the first month)
    2. Range: Second trimester to 5 months postpartum

IV. Risk Factors

  1. Advanced maternal age
  2. Preeclampsia
  3. Hypertension
  4. History of Peripartum Cardiomyopathy with prior pregnancy
  5. Multiple Gestation
  6. Multigravida
  7. Black race
  8. Poverty
  9. Cocaine Abuse
  10. Prolonged exposure to Tocolytic medications >4 weeks
    1. Bassett (1985) Obstet Gynecol 66(6): 755-61 [PubMed]

V. Findings

VI. Labs

VII. Differential Diagnosis

  1. See Cardiomyopathy
  2. Preeclampsia
  3. Postpartum Cardiomyopathy is a diagnosis of exclusion when no other Cardiomyopathy cause is identified

VIII. Imaging

IX. Diagnostics

  1. Electrocardiogram
    1. May be normal or only demonstrate Sinus Tachycardia
  2. Echocardiogram
    1. First-line study

X. Management

  1. See Congestive Heart Failure
  2. Pregnancy precautions
    1. Avoid ACE Inhibitors and Angiotensin Receptor Blockers
    2. Exercise caution with Diuretics (risk of Hypotension and uterine hypoperfusion)

XI. Prognosis

  1. Mortality (longterm): 11-16%
  2. Most women recover from Postpartum Cardiomyopathy
    1. Some women may have persistently reduced ejection fraction
    2. Future pregnancy mortality approaches 25% if ejection fraction has not returned to normal
    3. Hilfiker-Kleiner (2017) Eur J Heart Fail 19(12): 1723-8 [PubMed]

XII. References

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Related Studies

Ontology: Postpartum cardiomyopathy (C0269972)

Concepts Disease or Syndrome (T047)
ICD10 O90.3
SnomedCT 199277001, 62377009
English Cardiomyopathy in the puerp, Cardiomyopathy in the puerperium, Postpartum cardiomyopathy, cardiomyopathy puerperium, Cardiomyopathy in the puerperium (disorder), postpartum cardiomyopathy, cardiomyopathy postpartum, postpartum cardiomyopathy (diagnosis), Puerperal cardiomyopathy, Postpartum cardiomyopathy (disorder), cardiomyopathy; postpartum, cardiomyopathy; puerperal, postpartum; cardiomyopathy, puerperium; cardiomyopathy
German Kardiomyopathie im Wochenbett, Postpartale Kardiomyopathie
Korean 산후기중 심장근육병증
Spanish Miocardiopatía postparto, miocardiopatía postparto (trastorno), miocardiopatía postparto, miocardiopatía puerperal
Portuguese Miocardiopatia pós-parto
Italian Cardiomiopatia post partum
French Cardiomyopathie du post-partum
Dutch postpartum cardiomyopathie, cardiomyopathie; post partum, cardiomyopathie; puerperium, post partum; cardiomyopathie, puerperium; cardiomyopathie, Cardiomyopathie tijdens kraambed
Czech Poporodní kardiomyopatie
Japanese 分娩後心筋症, ブンベンゴシンキンショウ
Hungarian Postpartum cardiomyopathia

Ontology: Peripartum cardiomyopathy (C0877208)

Concepts Pathologic Function (T046)
ICD9 674.5
ICD10 O90.3
SnomedCT 16253001
Italian Cardiomiopatia peripartum
Japanese 周産期心筋症, シュウサンキシンキンショウ
English peripartum cardiomyopathy (diagnosis), peripartum cardiomyopathy, dilated cardiomyopathy secondary to peripartum heart disease, Peripartum cardiomyopathy, cardiomyopathy peripartum, Dilated cardiomyopathy secondary to peripartum heart disease, Dilated cardiomyopathy secondary to peripartum heart disease (disorder)
Czech Peripartální kardiomyopatie
Hungarian Peripartum cardiomyopathia
Spanish miocardiopatía dilatada secundaria a cardiopatía periparto (trastorno), miocardiopatía dilatada secundaria a cardiopatía periparto, Cardiomiopatía periparto
Portuguese Cardiomiopatia periparto
Dutch cardiomyopathie tijdens de bevalling
French Cardiomyopathie du péri-partum
German Peripartale Kardiomyopathie