Current management of peripartum cardiomyopathy: A review

Abstract

Background: Demarkis et al in 1971 described 27 patients who presented during pueperium with cardiomegaly, abnormal electrocardiographic findings, congestive heart failure and named the syndrome “peripartum cardiomyopathy”.The aim of this review is to document the current concepts in the management of peripartum cardiomyopathy.

Materials and Methods: A search of the literature was done using PubMed,Goggle scholar and books from authors' collections.

Results: The cause of the disease might be environmental and genetic factors. Diagnostic echocardiographic criteria include left ventricular ejection fraction of less than 45% or a combination of M- mode fractional shortening of less than 30% 2 and end diastolic dimension of greater than 2.7cm/m² . Electrocardiogram, magnetic resonance imaging, endomyocardial biopsy and cardiac catheterization aid in the diagnosis and management of peripartum cardiomyopathy. Treatment includes both conventional pharcomological heart failure and peripartum cardiomyopathy targeted therapies.Therapeutic decisions are influenced by drug safety profiles during pregnancy and lactation. Mechanical support and transplantation might be necessary in severe cases.

Conclusion: Peripartum cardiomyopathy is an uncommon but life threatening cardiac failure of unknown aetiology encountered in late pregnancy or postpartum period. Management aims at improving heart failure symptoms through conventional therapies and then at administering targeted therapies.The risk of recurrence in future pregnancies should always be considered.

Keywords: Cardiomyopathy,Heart failure,Peripartum