Peripartum Cardiomyopathy: JACC State-of-the-Art Review
MB Davis, Z Arany, DM McNamara, S Goland… - Journal of the American …, 2020 - jacc.org
MB Davis, Z Arany, DM McNamara, S Goland, U Elkayam
Journal of the American College of Cardiology, 2020•jacc.orgPeripartum cardiomyopathy is a form of systolic heart failure affecting young women toward
the end of pregnancy or in the months following delivery. Incidence is higher in African-
American women and in women with older maternal age, hypertensive disorders of
pregnancy, and multiple gestation pregnancies. Symptoms of heart failure mimic those of
normal pregnancy, often resulting in a delay in diagnosis and preventable complications.
Echocardiography showing decreased myocardial function is essential for the diagnosis …
the end of pregnancy or in the months following delivery. Incidence is higher in African-
American women and in women with older maternal age, hypertensive disorders of
pregnancy, and multiple gestation pregnancies. Symptoms of heart failure mimic those of
normal pregnancy, often resulting in a delay in diagnosis and preventable complications.
Echocardiography showing decreased myocardial function is essential for the diagnosis …
Abstract
Peripartum cardiomyopathy is a form of systolic heart failure affecting young women toward the end of pregnancy or in the months following delivery. Incidence is higher in African-American women and in women with older maternal age, hypertensive disorders of pregnancy, and multiple gestation pregnancies. Symptoms of heart failure mimic those of normal pregnancy, often resulting in a delay in diagnosis and preventable complications. Echocardiography showing decreased myocardial function is essential for the diagnosis. Medical management is similar to heart failure with reduced ejection fraction of other etiologies, but adjustments during pregnancy are necessary to ensure fetal safety. Variable outcomes include complete recovery, persistent heart failure, arrhythmias, thromboembolic events, and death. Subsequent pregnancy confers substantial risk of relapse and even death if there is incomplete myocardial recovery. Additional research about the etiology, optimal therapy including the use of bromocriptine, long-term outcomes, and duration of treatment after recovery are needed.
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