Peripartum Cardiomyopathy (PPCM) is a rare and serious heart condition that usually develops in the last trimester of pregnancy or in the first weeks after childbirth. It is due to insufficiency of the left ventricle of the heart, which leads to heart failure and a reduced ability of the heart to pump blood to the body. Due to poor heart function, fluid accumulates in the lungs and other parts of the body (edema).
The risk factors implicated in peripartum cardiomyopathy are:
- Hormonal changes.
- The increased load on the cardiovascular system due to pregnancy, especially in twin or multiple pregnancies.
- Genetic predisposition and family history of heart disease.
- Ages over 30-35 years of age which are more dangerous.
- Previous heart disease or hypertension.
- History of peripartum cardiomyopathy in previous pregnancies.
Symptoms of peripartum cardiomyopathy may include:
- Shortness of breath (especially with exercise or lying down),
- Fatigue,
- Swollen feet or ankles (edema),
- Generalized swelling or bloating in the abdomen (due to fluid retention),
- Pain in the chest or feeling weak.
- Fever and general weakness in more severe cases.
The prognosis of peripartum cardiomyopathy depends on the stage and management of the disease. Early diagnosis and treatment are critical to avoid permanent damage to the heart. Approximately 50% of women recover completely or show improvement in their heart condition after treatment, while others may continue to experience heart problems or develop permanent heart disease.
The diagnosis and management of perinatal cardiomyopathy should be performed by a Cardiologist with expertise in cardiomyopathy. Diagnosis at the Clinic includes:
Medical family history, auscultation of the heart, echocardiography to assess heart function and determine if there is left ventricular failure, electrocardiogram to record abnormalities in the heart rhythm, evaluation of cardiac markers that will result from specialized cardiac tests. Depending on the findings, a cardiac MRI may also be required.
If the diagnosis of peripartum cardiomyopathy is made due to symptoms before delivery, provision should be made for the presence of a Cardiologist who will take over immediate support after delivery, as worsening of the cardiac condition can occur immediately after birth.
The treatment of peripartum cardiomyopathy involves treating heart failure and improving cardiac function with specific medication, antiarrhythmic drugs to control arrhythmias, if present. Also, oxygen and respiratory support in case of severe dyspnea or pulmonary fluid retention.
Women with peripartum cardiomyopathy should be regularly monitored by a cardiologist to monitor the progress of their heart disease.
