An Outlook on: Peripartum Cardiomyopathy

Peripartum cardiomyopathy also known as postpartum cardiomyopathy. This condition is an uncommon form of heart failure which happens during the later stages of pregnancy. This condition weakens the heart muscle and heart gets enlarged.

Diagnosis:

Peripartum cardiomyopathy may be difficult to diagnose due to mimicking symptoms of heart failure those of third trimester pregnancy, such as swelling in the feet and legs, and shortness of breath. More extreme cases emphasize severe shortness of breath and prolonged swelling after delivery.

Some of the imaging tests can also view potential lung damage. Tests may include:

·   X-ray of the entire chest

·   CT scan for precised pictures of the heart

·   Nuclear heart scan to show heart chambers

·   Echocardiogram

Peripartum cardiomyopathy is diagnosed when the following three criteria are  met:

·   Heart failure develops in the last months of pregnancy

·   Heart pumping function is reduced, with an ejection fraction (EF) less than 45%

·   No other cause for heart failure with reduced EF can be found

Laboratory blood tests are a basic part of the evaluation. This includes tests to assess the functioning of kidney, liver and thyroid also tests to assess electrolytes, including sodium and potassium and a complete blood count to look for anaemia or evidence of infection. In addition, markers of cardiac injury and stress can be used to assess risk level.

Symptoms:

·   Fatigue

·   Chest pain

·   Palpitations

·   Nocturia

·   Shortness of breath

·   Swelling of the ankles

·   Swollen neck veins

·   Low blood pressure

·   Increased urination at night

·   Tiredness during physical activity

Severity of symptoms:

·   Class I - Disease with no symptoms

·   Class II - Mild symptoms

·   Class III - Symptoms with minimal exertion

·   Class IV - Symptoms at rest

Causes:

·   Obesity

·   History of cardiac disorders, such as myocarditis

·   Medications

·   Smoking

·   Alcoholism

·   Multiple pregnancies

·   African-American descent

·   Poor nourishment

·   Being over the age of 30

·   Premature delivery medications

Medications:

·  Angiotensin converting enzyme inhibitors – Help the heart work more efficiently

·    Beta blockers – helps to reduces the pace of heart beat so it has recovery time

·    Diuretics – Reduce fluid retention

·   Digitalis – Derived from the Digitalis purpurea, to treat heart failure. Digitalis strengthens the pumping ability of the heart

·  Anticoagulants – To help thin the blood. Patients with Peripartum cardiomyopathy are at increased risk of developing blood clots, especially if the EF is very low.

Complications associated with Peripartum cardiomyopathy

Severe complications include:

·   Arrhythmia

·   Blood clots, particularly in the lungs

·   Congestive heart failure

·   Sudden Death

Long-term outlook:

The condition depends on the severity and time frame of condition. Some women who develop the Peripartum Cardiomyopathy during pregnancy may recover and return to normal size after delivery. For others, their condition can continue to worsen. To preserve longevity, heart transplant is suggested.