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Peripartum Cardiomyopathy

Peripartum cardiomyopathy is a rare type of heart failure that happens late in pregnancy or in the months after delivery.

Because this condition may affect your pregnancy and cause lasting damage to your heart, prompt care is essential.

The cardiologists at the Magee-Womens Heart Program have expertise in treating women with peripartum cardiomyopathy.

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What Is Peripartum Cardiomyopathy?

Peripartum cardiomyopathy (also called postpartum cardiomyopathy or PPCM) is an uncommon condition in which a pregnant woman's heart pump weakens.

This condition happens at the end of a pregnancy or within the months after giving birth. It causes a reduced ejection fraction — meaning it lowers the amount of blood your heart pumps to the rest of the body.

As such, your heart can't pump enough blood and oxygen throughout your body and to your organs.

In the U.S., PPCM is rare. It only happens in 1 in about every 2500 deliveries.

Types of peripartum cardiomyopathy

The type and class of PPCM depend on the symptoms.

These symptoms can vary in severity which doctors label as PPCM with:

  • No symptoms = Class I.
  • Mild symptoms or effect on your heart function, or symptoms only with extreme exertion = Class II.
  • Symptoms with minimal exertion = Class III.
  • Symptoms at rest = Class IV.

Peripartum cardiomyopathy causes

Heart doctors aren't sure what exactly causes PPCM.

Most women receive a diagnosis of heart failure after delivery. But experts believe PPCM directly relates to changes to a woman's body during pregnancy.

Certain types of heart disease or your genes might also play a role in causing peripartum cardiomyopathy.

Many women with PPCM don't have a family history of heart failure.

Peripartum cardiomyopathy risk factors and complications

Women with the following may increase your risk of PPCM:

  • Poor nutrition.
  • Obesity.
  • Smoking.
  • Alcoholism.
  • Greater age.
  • Multiple pregnancies.
  • African-American descent.
  • Preeclampsia or high blood pressure.
  • A prior history of PPCM.

It's vital to treat this disease because it can further damage your heart. And, if you develop PPCM during pregnancy, it can affect your unborn baby's health.

Your doctor may plan an early delivery to prevent problems for both you and your baby.

Peripartum cardiomyopathy complications for the mother include:

  • Heart arrhythmias or an irregular heartbeat.
  • Blood clots in the heart that may travel to other places in your body and cause stroke or other serious conditions.
  • Congestive heart failure.

Your baby can also suffer from hypoxia, which means they can't get enough oxygen.

How to prevent peripartum cardiomyopathy

There is no surefire way to prevent PPCM.

It's crucial to tell your doctor if you have a history of heart damage or you've had PPCM in the past. That way, they can watch for any early signs.

Also, you can take these steps to keep your heart healthy and reduce your risk:

  • Avoid cigarettes and alcohol.
  • Eat a healthy diet.
  • Get regular exercise.

Why choose the Magee-Womens Heart Program for peripartum cardiomyopathy care?

At the Magee-Womens Heart Program, our cardiologists:

  • Have advanced training and expertise in heart conditions that affect women.
  • Work with your ob-gyn to diagnose, treat, and manage heart conditions like PPCM.
  • Aim to provide fast, effective care that offers the best outcome for you and your baby.

Peripartum Cardiomyopathy Symptoms and Diagnosis

The symptoms of peripartum cardiomyopathy are like those you might have late in a normal pregnancy. That can make this condition hard to detect, or it might cause you to delay going to the doctor.

Common symptoms of PPCM are:

  • Swelling in your feet, ankles, or legs.
  • Feeling tired.
  • Shortness of breath either with activity or when lying down.
  • Feeling like your heart is racing or skipping beats.
  • Increased nighttime urination.
  • Swollen neck veins.
  • Low blood pressure when you stand up.

Many women don't have symptoms until after their baby is born.

Call your doctor right away if you have any of these symptoms during or after your pregnancy.

Diagnosing peripartum cardiomyopathy

To diagnose PPCM, your doctor may:

  • Listen to your heart and lungs with a stethoscope.
  • Take your blood pressure.
  • Look at the veins in your neck to check for swelling.
  • Press on your belly to see if your liver feels large.
  • Run blood tests.
  • Take imaging scans of your heart.

Your doctor may order an echocardiogram to see how well your heart is pumping blood. This painless test uses sound waves to create pictures of your heart.

Your doctor will diagnose peripartum cardiomyopathy if:

  • A physical exam or lab work causes concern that you're in heart failure.
  • An echo shows a weakened heart muscle.

Peripartum Cardiomyopathy Treatment

Treatment goals for PPCM are to relieve any symptoms you may have and protect the health of you and your baby.

You may need to stay in the hospital until your symptoms are better and your condition improves.

Medicine to treatment peripartum cardiomyopathy

Doctors often use drugs to treat PPCM that can:

  • Help manage your heart rate.
  • Reduce the amount of fluid you retain so it doesn't collect in your lungs.
  • Help thin your blood so it doesn't form clots. Women with PPCM are at an increased risk of blood clots.

Your doctor will tell you whether or not you'll need medications for the long term.

They may also ask you to wear a vest that tracks your heart rhythm and prevents dangerous irregular heart rhythms.

Lifestyle changes to help treat peripartum cardiomyopathy

Your doctor might also urge you to make certain lifestyle changes to help your heart work better, such as:

  • Quitting smoking if you smoke cigarettes.
  • Avoiding alcohol.
  • Eating a low salt diet.
  • Restricting the amount of fluids you drink.

Make sure to talk with your doctors about future pregnancies. Another pregnancy may be dangerous to you and your future baby if your heart isn't strong enough.

There are many safe and effective forms of birth control you can use with PPCM.

Is there a cure for peripartum cardiomyopathy?

Many women fully recover or remain stable and healthy for a long time with the help of medicines and lifestyle changes. But in some women, their heart function can remain weak or get worse with time.

If your heart becomes too damaged, you may need mechanical support. These devices help your heart pump blood to the rest of your organs or prevent life-threatening heart rhythms.

These might include an:

  • LVAD (left ventricular assist device) — a small machine placed into the heart that pumps blood to your other organs.
  • ICD (implantable cardioverter-defibrillator) — a battery-operated device placed in your chest to prevent dangerous heart rhythms.

A small percent of women with severe PPCM need a heart transplant.