RT Book, Section
A1 Elkayam, Uri
A1 Pizula,  Jena
A2 Fuster, Valentin
A2 Narula, Jagat
A2 Vaishnava, Prashant
A2 Leon, Martin B.
A2 Callans, David J.
A2 Rumsfeld, John S.
A2 Poppas, Athena
SR Print(0)
ID 1202455328
T1 Peripartum Cardiomyopathy
T2 Fuster and Hurst's The Heart, 15e
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264257560
LK accesscardiology.mhmedical.com/content.aspx?aid=1202455328
RD 2024/04/18
AB Chapter  SummaryThis  chapter  reviews  the  epidemiology,  pathophysiology,  and  management  of  peripartum  cardiomyopathy  (PPCM),  an  idiopathic  cardiomyopathy  presenting  with  heart  failure  due  to  severe  left  ventricular  systolic  dysfunction.  Presentation  is  usually  during  the  first  month  after  delivery  but  can  be  during  the  second  or  third  trimester  of  pregnancy  or  a  few  months  postpartum  (see  Fuster  and  Hurst’s  Central  Illustration).  The  incidence  of  PPCM  in  the  United  States  is  approximately  1  in  3000  live  births  and  is  significantly  higher  in  Black  women  than  in  White  women.  The  incidence  worldwide  varies  and  is  higher  in  Africa  and  Haiti  than  in  Europe  and  the  United  States.  Risk  factors  for  the  condition  include  advanced  age,  preeclampsia,  Black  ethnicity,  and  multifetal  pregnancy.  Normalization  of  left  ventricular  function  occurs  in  >50%  of  women  in  the  United  States,  mostly  within  2  to  6  months  after  diagnosis.  Reported  recovery  rates  in  other  countries  vary.  Although  many  patients  do  improve,  PPCM  can  be  associated  with  important  and  lasting  complications.  Moreover,  subsequent  pregnancy  in  women  with  a  history  of  PPCM  can  be  associated  with  relapse  with  reduced  ejection  fraction  and  worsening  of  symptoms;  this  is  more  likely  in  women  with  persistent  left  ventricular  dysfunction  prior  to  their  subsequent  pregnancy  but  occasionally  occurs  in  women  with  recovered  left  ventricular  function.