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Peripartum cardiomyopathy


Authors: J. Krejčí
Authors‘ workplace: I. interní kardioangiologická klinika FN u sv. Anny – ICRC, Brno
Published in: Kardiol Rev Int Med 2011, 13(4): 221-224

Overview

Peripartum cardiomyopathy is a disease characterized by systolic heart failure occurring towards the end of pregnancy and in the months following delivery and excluding other aetiology of this condition. It is a rare disease whose incidence varies, according to data from USA, in the range of 1 case per 2,000–4,000 births, with incidence in some regions of the world being up to 10 times higher. The clinical picture corresponds to that of other causes of heart failure; the rapid development of symptoms in relation to pregnancy is notable. A major diagnostic procedure is echocardiography, while cardiac magnetic resonance imaging could be beneficial and endomyocardial biopsy is sometimes performed. The aetiology of the disease is unclear and most spe­culation concerns myocarditis, autoimmune involvement, cardiotropic viral infection, abnormal response to haemodynamic and hormonal changes during pregnancy and also, currently, increased levels of oxidative stress, inducing production of proapoptotic, proinflammatory and angiostatic mediators. While the restoration of left ventricular function is seen in 25–50% of cases, the outcome is sometimes fatal or requires a heart transplant. In addition to standard therapy for heart failure, other therapeutic concepts (pentoxifylline, bromocriptine and immunomodulation) are also undergoing tests. Recurrence of the disease in subsequent pregnancies is common and therefore further pregnancies are not recommended in the majority of cases.

Keywords:
peripartum cardiomyopathy – aetiology – diagnosis – treatment


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Labels
Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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