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Selma Carlson,1,2 Jessica Schultz,1 Bhavadharini Ramu,3 Melinda B Davis4 1Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA; 2Division of Cardiology, Minneapolis VA Medical Center, Minneapolis, MN, USA; 3Division of Cardiology, Department of Medicine, Medical University of South Carolina (MUSC), Charleston, SC, USA; 4Division of Cardiovascular Medicine, Department of Medicine, University of Michigan, Ann Arbor, MI, USACorrespondence: Selma Carlson, Division of Cardiology, Department of Medicine, Minneapolis VA Health Care System, Minneapolis, MN, USA, Email selma.carlson@va.govAbstract: Peripartum cardiomyopathy is a rare cause of heart failure that occurs during late pregnancy or in the early postpartum period. Delays in diagnosis may occur as symptoms of heart failure mimic those of normal pregnancy. The diagnosis should be considered in any pregnant or postpartum woman with symptoms concerning for heart failure. If there are clinical concerns, labs including N-terminal pro-BNP should be checked, and an echocardiogram should be ordered to assess for systolic dysfunction. Prompt medical treatment tailored for pregnancy and lactation is essential to prevent adverse events. Outcomes are variable, including complete recovery, persistent myocardial dysfunction with heart failure symptoms, arrhythmias, thromboembolic events, and/or rapid deterioration requiring mechanical circulatory support and cardiac transplantation. It is essential that care is provided as part of a multidisciplinary cardio-obstetrics team including obstetrics, cardiology, maternal fetal medicine, anesthesiology, and nursing. All women with peripartum cardiomyopathy should have close follow-up with a cardiologist, although optimal duration of medical therapy following complete recovery is unknown. Women considering a subsequent pregnancy require preconception counseling and close collaboration between obstetrics and cardiology throughout pregnancy.Keywords: peripartum, cardiomyopathy, pregnancy, heart failure |
