II. Definitions
- Postpartum Cardiomyopathy
- Left Ventricular Systolic Dysfunction onset in late pregnancy or first 5 months postpartum
III. Epidemiology
- Incidence: 1:1000 to 4000 live births
- Onset
- Typical: First week after delivery (up to the first month)
- Range: Second trimester to 5 months postpartum
IV. Risk Factors
- Advanced maternal age
- Preeclampsia
- Hypertension
- History of Peripartum Cardiomyopathy with prior pregnancy
- Multiple Gestation
- Multigravida
- Black race
- Poverty
- Cocaine Abuse
- Prolonged exposure to Tocolytic medications >4 weeks
V. Findings
- See Congestive Heart Failure
- Dyspnea on exertion
- Paroxysmal Dyspnea on exertion
- Orthopnea
- Lower Extremity Edema
VI. Labs
- See Congestive Heart Failure
- Serum Chemistry Panel
- Brain Natriuretic Peptide
VII. Differential Diagnosis
- See Cardiomyopathy
- Preeclampsia
- Postpartum Cardiomyopathy is a diagnosis of exclusion when no other Cardiomyopathy cause is identified
VIII. Imaging
IX. Diagnostics
-
Electrocardiogram
- May be normal or only demonstrate Sinus Tachycardia
-
Echocardiogram
- First-line study
X. Management
- See Congestive Heart Failure
- Pregnancy precautions
- Avoid ACE Inhibitors and Angiotensin Receptor Blockers
- Exercise caution with Diuretics (risk of Hypotension and uterine hypoperfusion)
XI. Prognosis
- Mortality (longterm): 11-16%
- Most women recover from Postpartum Cardiomyopathy
- Some women may have persistently reduced ejection fraction
- Future pregnancy mortality approaches 25% if ejection fraction has not returned to normal
- Hilfiker-Kleiner (2017) Eur J Heart Fail 19(12): 1723-8 [PubMed]
XII. References
- Lively and Clare (2022) Crit Dec Emerg Med 36(5): 4-10
- Brieler (2017) Am Fam Physician 96(10):640-6 [PubMed]
- Sliwa (2010) Eur J Heart Fail 12(8): 767-8 [PubMed]
Images: Related links to external sites (from Bing)
Related Studies
| 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, ﾌﾞﾝﾍﾞﾝｺﾞｼﾝｷﾝｼｮｳ |
| 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 |
