Peripartum cardiomyopathy (PPCM)

Peripartum cardiomyopathy (PPCM) occurs in the last months of pregnancy and up to five months after delivery. Arrhythmias are sometimes a complication of PPCM, a form of dilated cardiomyopathy. This is a condition in which the heart becomes weakened and enlarged and cannot pump blood efficiently. This can lead to heart failure, with fluid buildup in the lungs or other parts of your body, arrhythmias and even sudden cardiac death. Patients usually have no prior history of heart disease or heart failure. Cardiac ECHOs are used to diagnose and monitor its treatment.

The severity of symptoms in patients with PPCM can be classified by the New York Heart Association system as follows:

  • Class I - Disease with no symptoms
  • Class II - Mild symptoms/effect on function or symptoms only with extreme exertion
  • Class III - Symptoms with minimal exertion
  • Class IV - Symptoms at rest

Symptoms  such as dyspnea, dizziness and decreased exercise capacity may occur in pregnant women. Mild dyspnea on exertion is also common in a normal pregnancy and therefore patients may present with heart failure or a major adverse event such as a stroke or respiratory failure without any previous signs or symptoms. Fetal distress may be a result of the mother's heart failure: a healthy fetus depends on a healthy mother!

Treatment may be complicated and require transfer to a hospital with facilities available to care for both mother and child.

The prognosis is dependent on recovery of the heart function. Thirty percent of patients return to baseline heart function within 6 months, and 50% of patients have significant improvement in symptoms.