What is Peripartum Cardiomyopathy?

Peripartum cardiomyopathy (PPCM) is a heart condition associated with pregnancy. Often presenting during the third trimester or within weeks of delivery, mild cardiomyopathic symptoms may subside independently without treatment. Defined by decreased heart function, acute cardiomyopathic symptoms generally necessitate timely and appropriate medical attention to ensure a good prognosis. Peripartum cardiomyopathy treatment may range from the use of medication to pacemaker implantation or heart transplantation depending on the severity of one’s condition.

Signs of cardiomyopathy are generally detected during a physical examination. Atypical lung sounds and, in some cases, an irregular heart rhythm may present with fluid accumulation within the chest cavity. If a cardiomyopathic diagnosis is suspected, tests designed to evaluate heart condition and functionality may be performed, such as an echo- and electrocardiogram, both of which may be safely performed during pregnancy. In cases where the mother's condition necessitates additional testing that may involve radiation exposure, such as X-ray, precautionary measures are taken to ensure that risk to the fetus’ health is minimal.

Often affecting the left ventricle, peripartum cardiomyopathy is generally idiopathic in origin, meaning there is no definitive cause for its development. As the affected chamber distends, it loses flexibility, requiring additional pressure to conduct blood into the aorta for systemic distribution. The absence of sufficient pressure ultimately impairs blood circulation and increases stress on the heart. With time, limited blood circulation not only further compromises heart function, but places other bodily systems and organs in jeopardy.

There are several factors that may contribute to the development of peripartum cardiomyopathy. Existing heart disease, obesity, and smoking significantly increase a woman’s chance for cardiovascular complications during pregnancy. Substance abuse, such as alcoholism, and chronic medical conditions, including diabetes, may also contribute to symptom development.

Women with peripartum cardiomyopathy will often become easily fatigued and short of breath. Reduced blood circulation to the brain can contribute to episodic feelings of dizziness or lightheadedness. With time, compromised heart function can contribute to widespread swelling, especially in the lower extremities, and a significant decline in one’s physical stamina. Some individuals may also experience pronounced, fluid-based weight gain and a noticeable fluttering or skipped heartbeat. If peripartum cardiomyopathy symptoms are ignored, the risk for complications such as heart failure and cardiac arrest increases dramatically.

Acute cases of peripartum cardiomyopathy can necessitate hospitalization. Treatment approach is entirely dependent on the severity of one’s condition. Initial treatment may involve the administration of medication to flush excess fluids from the body, regulate heart rate, and strengthen the heart. If heart function is significantly impaired by peripartum cardiomyopathy or the muscle has sustained irreparable damage, pacemaker implantation or heart transplantation may be necessary.