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3.4.6 Peripartum cardiomyopathy
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Published:November 2023
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Abstract
This chapter provides the definition and describes the investigations and management recommendations for physicians dealing with peripartum cardiomyopathy (PPCM). It gives details on risk stratification and morbidity and mortality. PPCM is a disease that occurs globally in all ethnic groups. It is a diagnosis of exclusion but should be suspected in any peripartum women presenting with symptoms and signs of heart failure towards the end of their pregnancy or in the months following delivery. These women should be thoroughly assessed and alternative causes should be excluded. Urgent cardiac investigation with electrocardiography and natriuretic peptide measurement (if available) should be performed. Echocardiography is the next step in investigation, prior to more advanced imaging where this is available. Patients with abnormal cardiac investigations should be urgently referred to a cardiology team for expert management. Just under half of women with PPCM experience myocardial recovery. PPCM is a disease with substantial maternal and neonatal morbidity and mortality; mortality rates range widely from 0% to 30%, depending on ethnic background and geographical region. Compared to other cardiomyopathies, PPCM patients have better prognosis in terms of survival and recovery of left ventricular function.
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