English

Abstract

Peripartum cardiomyopathy (PPCM) is a rare but sometimes life-threatening form of dilated cardiomyopathy. The exact cause is unclear. It is associated with excess morbidity and mortality in women of childbearing age. Incidence of PPCM ranges from 1 in 2000 to 4000 pregnancies. The diagnostic criteria are onset of heart failure in the last month of pregnancy or in first 5 months postpartum, absence of determinable cause for cardiac failure, and absence of a demonstrable heart disease before the last month of pregnancy. There must be echocardiographic features of left ventricular dysfunction. The known risk factors include multiparity, twin births, advanced maternal age, preeclampsia, gestational hypertension, and black race. The usual clinical presentation of patients with peripartum cardiomyopathy is similar to that of patients with systolic congestive heart failure. Treatment is limited to use of drugs for symptomatic control, although recent studies indicate the usefulness of new drugs. About half the patients of peripartum cardiomyopathy recover without any complications. The prognosis is poor in patients with persistent cardiomyopathy. Persistence of disease after 6 months indicates irreversible cardiomyopathy and portends worse survival. Recurrence in subsequent pregnancies remains high. In this case report, we describe the unusual presentation of PPCM in a young woman with term pregnancy.