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Peripartum cardiomyopathy is a rare type of cardiomyopathy that affects childbearing women at any age. In the US, this disorder affects 1 in every 1,300 – 4,000 pregnancies and tends to be diagnosed in the final months of pregnancy or within the first five months after childbirth.

Symptoms

Possible symptoms of peripartum cardiomyopathy include:

• Palpitations (abnormal and rapid heart beats)
• Rapid pulse rate
• Fatigue (especially when exercising)
• Increased frequency of urination at night
• Shortness of breath (when lying flat or exercising)
• Difficulty breathing
• Water retention
• Swollen hands, feet, ankles, and legs
• Neck veins may be swollen
• Loss of appetite
• Weight gain
• Fainting spells

Peripartum cardiomyopathy can develop complications such as congestive heart failure, blood clots in the lungs and cardiac arrhythmias that could be fatal if not treated in time. If you are pregnant or have just had a baby and suffer from any of the above symptoms, consult your doctor immediately.

Causes

Cardiomyopathy occurs when there is damage to the heart. This damage prevents the heart from functioning properly and affects the circulation of blood to various parts of the body. Therefore a weakened heart affects the functioning of the lungs, liver, stomach and other organs of the body.

Experts are still unaware of the exact cause of peripartum cardiomyopathy. However, certain risk factors have been identified that may increase a person’s chance of developing the condition. These include:

• Multiple pregnancies
• Obesity
• Advanced maternal age
• Preeclampsia
• Gestational hypertension
• Alcoholism
• Smoking
• Malnutrition
• Other cardiac disorders such as myocarditis
• Certain medications
• Research also shows that African American women are more prone to this condition than others

Diagnosis

During a physical examination, your doctor will look out for certain signs that may indicate the development of cardiomyopathy. He will check for signs of fluid in the lungs using a stethoscope to listen for crackles in the lungs, a rapid heartbeat or any abnormal sounds. Your doctor will also check for swelling in the liver and also pay careful attention to changes in blood pressure that could be low but increase when you stand up. Other tests used to diagnose peripartum cardiomyopathy and indicate signs of heart failure are:

• Chest x-ray
• CT scan of the chest
• Coronary angiography
• Echocardiogram
• Nuclear heart scan
• Heart biopsy (only in cases where myocarditis has been diagnosed or is suspected)

Treatment

Treatment for peripartum cardiomyopathy aims at relieving symptoms. In some cases, a few symptoms may get resolved without any treatment. Possible forms of treatment include:

• Medications to strengthen the heart and improve its ability to pump blood
• Water pills or diuretics to prevent water retention and remove excess fluid
• Beta-blockers (low-dose)

However, in more severe cases, the symptoms are could be severe and hospitalization would be necessary. In order to improve the survival rate some of the following extreme measures may be taken:

• Using a balloon heart pump to improve functioning of the heart
• Immunosuppressive therapy
• Heart transplant if severe congestive heart failure persists

Other recommendations to help relieve symptoms of peripartum cardiomyopathy are:

• Follow a low-salt diet as this can help prevent water retention
• Some cases may require fluid restriction
• Activities such as nursing may have to stop when symptoms are severe
• Monitor blood pressure, weight and blood sugar levels on a daily basis to keep track of the disease’s progress
• Stop smoking and drinking

The outlook for women with peripartum cardiomyopathy is good if the heart returns to its normal size after the delivery. If the heart remains enlarged and the symptoms worsen, it may result in heart failure and death. Women with this condition are at a higher risk of developing the same problem with future pregnancies. However experts and doctors still do not know how to predict who will recover and who will develop severe heart failure.

References

• http://www.nlm.nih.gov/medlineplus/ency/article/000188.htm
• http://www.umm.edu/ency/article/000188.htm#ixzz1tKfTorsR
• http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001240/

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