Navigate Up

Orthopaedics Center - A-Z Index

#
I
Q
Y
Z

Print This Page

Peripartum cardiomyopathy

Peripartum cardiomyopathy is a rare disorder in which a pregnant woman's heart becomes weakened and enlarged. It develops during the last month of pregnancy, or within 5 months after the baby is born.

Alternative Names

Cardiomyopathy - peripartum

Causes

Cardiomyopathy occurs when there is damage to the heart. As a result, the heart muscle becomes weak and does not pump well. This affects the lungs, liver, and other body systems.

Peripartum cardiomyopathy is a form of dilated cardiomyopathy in which no other cause of heart weakening can be found.

It may occur in childbearing women of any age, but it is most common after age 30.

Risk factors for the condition include:

  • Obesity
  • Personal history of cardiac disorders such as myocarditis
  • Use of certain medications
  • Smoking
  • Alcoholism
  • Multiple pregnancies
  • African-American descent
  • Poor nourishment

Symptoms

Exams and Tests

During a physical exam, the health care provider will look for signs of fluid in the lungs by touching and tapping with the fingers. A stethoscope will be used to listen for lung crackles, a rapid heart rate, or abnormal heart sounds.

The liver may be enlarged and neck veins may be swollen. Blood pressure may be low or may drop when standing up.

Heart enlargement, congestion of the lungs or the veins in the lungs, decreased cardiac output, decreased movement or functioning of the heart, or heart failure may show up on:

A heart biopsy may help determine if the underlying cause of cardiomyopathy is a heart muscle infection (myocarditis). However, this procedure is not done very often.

Treatment

A woman may need to stay in the hospital until acute symptoms subside.

Because it is very often possible to restore heart function, and the women who have this condition are often young, everything possible is done to treat the problem.

This may include extreme steps such as:

  • Use of a balloon heart pump (aortic counterpulsation balloon)
  • Immunosuppressive therapy (such as medicines used to treat cancer or prevent rejection of a transplanted organ)
  • Heart transplant if severe congestive heart failure persists

For most women, however, treatment mainly focuses on relieving the symptoms. Some symptoms go away on their own without treatment.

Medicines that are often used include:

  • Digitalis to strengthen the heart's pumping ability
  • Diuretics ("water pills") to remove excess fluid
  • Low-dose beta-blockers

A low-salt diet may be recommended. Fluid may be restricted in some cases. Activities, including nursing the baby, may be limited when symptoms develop.

Daily weighing may be recommended. A weight gain of 3 - 4 pounds or more over 1 or 2 days may be a sign of fluid buildup.

Women who smoke and drink alcohol will be advised to stop, since these habits may make the symptoms worse.

Outlook (Prognosis)

There are several possible outcomes in peripartum cardiomyopathy. Some women remain stable for long periods, while others get worse slowly.

Others get worse very quickly and may be candidates for a heart transplant. The death rate may be as high as 25 - 50%.

The outlook is good for women whose hearts returns to normal size after the baby is born. If the heart remains enlarged, future pregnancies may result in heart failure. It is not known how to predict who will recover and who will develop severe heart failure.

Women who develop peripartum cardiomyopathy are at high risk of developing the same problem with future pregnancies. They should discuss birth control methods with their health care provider.

Possible Complications

When to Contact a Medical Professional

Call your health care provider if you are currently pregnant or have recently delivered a baby and think you may have signs of cardiomyopathy.

Get medical help right away if you develop chest pain, palpitations, faintness, or other new or unexplained symptoms.

Prevention

Eat a well-balanced diet and get regular exercise to help keep your heart strong. Avoid cigarettes and alcohol. Your doctor may advise you to avoid getting pregnant again if you have had heart failure during a previous pregnancy.

References

McKenna W. Diseases of the myocardium and endocardium. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 60.

Warnes CA. Pregnancy and heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 82.

Updated: 5/13/2014

Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com