Peripartum cardiomyopathy

Abstract

Peripartum cardiomyopathy (PPCM) is an uncommon but important form of left ventricular systolic dysfunction with global implications. Its pathophysiology is likely multifactorial and may include a genetic predisposition. Our understanding of PPCM has been challenged by the lack of prospective studies and large registries. The clinical presentation, diagnostic assessment, and treatment usually mirror those of other forms of dilated cardiomyopathy. However, pregnancy status and breastfeeding are important considerations. While acknowledging that a fair number of patients with PPCM will have recovery of cardiac function, advanced heart failure therapies should be considered in a timely manner to improve short- and long-term outcomes. Subsequent pregnancies are associated with increased risk for the mother and fetus and generally should be discouraged, even in the setting of normalized ventricular function. Further advances in the knowledge of PPCM will stem from an emerging prospective study and through creating large-scale national/international registries.