Peripartum Cardiomyopathy

Peripartum Cardiomyopathy

Alisa Anderson

Eric J. Lee

Rebecca Barron


Peripartum cardiomyopathy (PPCM) can be an elusive diagnosis with a clinical presentation that is similar to signs and symptoms of a normal pregnancy. Although it is a rare cause of heart failure, it is important to consider in the emergency department (ED) as a missed or delayed diagnosis has potential for significant morbidity and mortality. Overall incidence varies geographically, and in the United States it is reported to range from 1 case per 1000 to 4000 live births.1,2 The pathophysiology is thought to be distinct from other cardiomyopathies but is still poorly understood.1 Treatment is that of standard medical therapy for heart failure excluding drugs contraindicated in pregnancy or with breastfeeding.1 Further studies elucidating the etiology of heart failure are needed to develop potential targeted therapies. Recognition of this clinical entity is challenging but key to providing optimal care for this affected patient population.


PPCM is defined as a new diagnosis of systolic cardiomyopathy with echocardiographic evidence of left ventricular ejection fraction (EF) less than 45%, without a reversible cause, in a female with no known coronary artery disease in the last month of pregnancy or up to 5 months postpartum.2 Reversible etiologies of systolic cardiomyopathy include infection, preexisting hypertension, valvular heart disease, toxin or drug mediated, and ischemia. Although PPCM is defined as occurring within the last month of pregnancy and 5 months postpartum, it has also been diagnosed outside this time frame. Given the diagnostic criteria, PPCM is a diagnosis that can be suspected but not definitively made during the initial ED presentation.

Dec 30, 2020 | Posted by in EMERGENCY MEDICINE | Comments Off on Peripartum Cardiomyopathy
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