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 UPMC have expertise in treating women with peripartum cardiomyopathy.

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On this page

• What Is Peripartum Cardiomyopathy?
• What Are the Symptoms of Peripartum Cardiomyopathy?
• How Do You Diagnose Peripartum Cardiomyopathy?
• How Do You Treat Peripartum Cardiomyopathy?

What Is Peripartum Cardiomyopathy?

Peripartum cardiomyopathy (also called postpartum cardiomyopathy or PPCM) is an uncommon condition that causes a pregnant woman to develop heart failure.

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

When this happens your heart can't pump enough blood and oxygen to your organs.

How common is PPCM?

In the U.S., PPCM is rare. It only happens in 1 in about every 2,500 deliveries.

What are the types of PPCM?

The type and class of PPCM depend on the symptoms, which may vary in severity. Classes of PPCM include:

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

What causes PPCM?

Heart doctors aren't sure what exactly causes PPCM.

Most women receive a diagnosis of heart failure after delivery. But experts believe PPCM is caused by 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. However, many women with PPCM don't have a family history of heart failure.

What are PPCM risk factors and complications?

PPCM risk factors

Several factors may increase your risk of developing PPCM, including:

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

H4: Complications of PPCM

It's vital to treat PPCM to reduce the risk of long-term damage to 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 reduce the risk of problems for you and your baby.

Peripartum cardiomyopathy complications for the mother include:

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

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

How can I prevent PPCM?

There is no way to prevent PPCM. However, you can take steps to keep your heart healthy and reduce your risk by:

• Avoiding cigarettes and alcohol.
• Eating a healthy diet.
• Getting regular exercise.

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

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What Are the Signs and Symptoms of PPCM?

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.

What are the signs of heart failure in pregnancy?

Common symptoms of PPCM are:

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

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

When should I see a doctor about my PPCM symptoms?

Call your doctor right away if you have any of these symptoms during or after your pregnancy. If your symptoms are sudden or severe, dial 911 or visit the nearest hospital emergency room.

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How Do You Diagnose PPCM?

If you have symptoms of PPCM or a history of heart problems, your doctor will screen you for the condition.

What to expect during your visit

To diagnose PPCM, your doctor may:

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

Tests to diagnose PPCM

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 echocardiogram shows a weakened heart muscle.

PPCM prognosis

With proper treatment, about half of the women who develop PPCM deliver healthy babies and go on to make a full recovery. For a small number of women, PPCM is severe, progresses quickly, or doesn’t completely go away. However, even if a woman recovers completely, PPCM may happen again with future pregnancies.

What is the life expectancy of someone with peripartum cardiomyopathy?

Women with PPCM can live full and active lives. Around 50 percent of women make a complete recovery, and most women can manage their condition with ongoing treatment. If you have been diagnosed with PPCM or your doctor suspects you may have PPCM, you should be evaluated by a heart failure specialist.

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How Do You Treat PPCM?

Treatment goals for PPCM are to relieve symptoms and protect you and your baby. You may need to stay in the hospital until your symptoms are better and your condition improves.

PPCM treatment options may include:

Lifestyle changes

Your doctor might recommend lifestyle changes to help your heart work better, such as:

• Avoiding alcohol.
• Eating a low-salt diet.
• Quitting smoking if you smoke cigarettes.
• 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.

Medicine to treat PPCM

Doctors often use drugs to treat PPCM. Medications 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 if 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.

Mechanical heart support for PPCM

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

These might include an:

• Left ventricular assist device (LVAD) – An LVAD is a small machine placed into your heart that pumps blood to your other organs.
• Implantable cardioverter-defibrillator (ICD) – An ICD is a battery-operated device placed in your chest to monitor and treat dangerous heart rhythms.

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

How effective is treatment?

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. Your doctor will discuss your condition, treatment, and prognosis with you.

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Why Choose UPMC for PPCM Care?

At UPMC, 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.
• Collaborate with specialists at the UPMC Magee-Womens Heart Program.

By UPMC Editorial Staff. Last reviewed on 2024-10-01 by Jennifer Kliner, CRNP.