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Peripartum Cardiomyopathy

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Peripartum Cardiomyopathy, Postpartum Cardiomyopathy

  • Definition
  1. Left Ventricular Systolic Dysfunction onset in late pregnancy or first few months postpartum
  • Epidemiology
  1. Incidence: 1:1000 to 4000 live births
  2. Onset
    1. Typical: First month after delivery
    2. Range: Second trimester to 4 months postpartum
  • Risk Factors
  1. Advanced maternal age
  2. Black race
  3. Preeclampsia
  4. Hypertension
  5. History of Peripartum Cardiomyopathy with prior pregnancy
  6. Multiple Gestation
  • Differential Diagnosis
  • Diagnosis
  1. Electrocardiogram
    1. May be normal or only demonstrate Sinus Tachycardia
  2. Echocardiogram
    1. First-line study
  • 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)
  • Prognosis
  1. Mortality (longterm): 11-16%
  2. Most women recover from Postpartum Cardiomyopathy