Cardiomyopathy - peripartum
Key points
- Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within the last month of pregnancy, or within 5 months after delivery.
- Peripartum cardiomyopathy is a form of dilated cardiomyopathy without other identifiable causes of heart dysfunction (weakened heart).
- During a physical examination, the physician will look for signs of fluid in the lungs by touch and tapping with the fingers.
- Hospitalization may be required until acute symptoms subside.
Alternative names
Peripartum cardiomyopathy
Definition
Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within the last month of pregnancy, or within 5 months after delivery.
Cardiomyopathy occurs when there is damage to the heart. The heart muscle becomes weakened and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.
Causes, incidence, and risk factors
Peripartum cardiomyopathy is a form of dilated cardiomyopathy without other identifiable causes of heart dysfunction (weakened heart).
In the United States, peripartum cardiomyopathy complicates 1 in every 1,300 to 4,000 deliveries. It may occur in childbearing women of any age, but it is most common after age 30.
Other risk factors include obesity, having a personal history of cardiac disorders (such as myocarditis), use of certain medications, smoking, alcoholism, multiple pregnancy, being African-American, and being malnourished.
Symptoms
- Shortness of breath
o on exertion
o when lying flat (orthopnea) - Fatigue
- Swelling of the ankles
- Increased frequency of night-time urination (nocturia)
- Feeling of racing or skipping of the heart (palpitations)
Signs and tests
During a physical examination, the physician will look for signs of fluid in the lungs by touch and tapping with the fingers. Listening to the chest with a stethoscope reveals lung crackles, a rapid heart rate, or abnormal heart sounds.
The liver may be enlarged and neck veins may be swollen. Blood pressure may be low or may drop when rising to a standing position.
Heart enlargement, congestion of the lungs or the veins in the lungs, decreased cardiac output, decreased movement or functioning of the heart, or heart failure may show on:
- Echocardiogram
- Chest x-ray
- Chest CT scan
- Coronary angiography
- Nuclear heart scan (MUGA, RNV)
An ECG can show enlargement of the heart; problems with the electrical part of the heart, called conduction disturbances; and arrhythmias, such as atrial fibrillation, ventricular tachycardia, or an ectopic heartbeat (premature or abnormal beat). A heart biopsy may be helpful to determine an underlying cause of the cardiomyopathy.
Written and revised by
David Cohen, M.D.
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