Abstract
Peripartum cardiomyopathy (PPCM) can be classified as a variant of dilated cardiomyopathy identified usually within the first five months of delivery or during the last month of pregnancy. This condition presents as systolic heart failure. PPCM affects thousands of women in the United States each year. Even though it was first noticed in the 1800s, its etiology remains unknown. This study aims to review the pathophysiology and management of PPCM and explore the possible outcomes of peripartum cardiomyopathy. PPCM can lead to maternal death if diagnosis or treatment is delayed. Diagnosing PPCM has been challenging because it can be misdiagnosed or perceived as a sign of pregnancy since most of the symptoms of PPCM strongly match those within the typical pregnancy continuum and postpartum cycle. Patients' implications are fatal and carry a high mortality rate when PPCM is misdiagnosed or treatment is delayed. To accurately identify PPCM, using echocardiography, the left ventricular end-diastolic size and the ejection fraction should be measured to determine the severity of PPCM. Managing peripartum cardiomyopathy involves using traditional treatments for heart failure. Therapeutic recommendations are made depending on the patient's status (pregnancy, breastfeeding, postpartum) while considering the drug-safety profiles before administration. Some other treatments have also been used to control PPCM depending on how severe it has become; for example, antiarrhythmics have been used to treat cardiac arrhythmias when they ensue. In extreme cases, mechanical assistance and transplantation could be required. Based on the proposed pathophysiology involving the 16kDA anti-angiogenic sub-fragment, bromocriptine may be used even though it still needs more assessment due to limited evidence.Using PubMed as a major search resource, a thorough analysis of publications was carried out after incorporating this review's inclusion and exclusion criteria. A total of 455,141 publications were found using keywords and keyword combinations. With a careful selection of articles, 31 publications provided relevant information on our primary endpoint. All articles in this examination were chosen without limitation to the type of study, including clinical trials, review articles, meta-analyses, and so on. Our review suggests that, based on factors such as early detection and management, disease severity, ethnicity, and quality of patient care, patients with PPCM presented different outcomes and prognosis. However, despite PPCM's high mortality rate and its risk of recurrence, most patients tend to recover within six months of disease onset.
Highlights
IntroductionBackgroundThe incidence of peripartum cardiomyopathy (PPCM) varies geographically
BackgroundThe incidence of peripartum cardiomyopathy (PPCM) varies geographically
Peripartum cardiomyopathy is heart disease with multiple manifestations and unexplored pathogenesis; it shares the most similarities with dilated cardiomyopathy, which presents as a systolic dysfunction due to ventricular dilation
Summary
BackgroundThe incidence of peripartum cardiomyopathy (PPCM) varies geographically. In the United States, it can be estimated as one in 4000 live births affecting women each year while in African countries like Nigeria, there is a higher incidence, estimated as one in 100 live births per year [1]. Peripartum cardiomyopathy, which is called postpartum cardiomyopathy, is a rare form of heart disease that normally presents in the last month of pregnancy or the first five months postpartum in the absence of any other identifiable heart disease. Peripartum cardiomyopathy is heart disease with multiple manifestations and unexplored pathogenesis; it shares the most similarities with dilated cardiomyopathy, which presents as a systolic dysfunction due to ventricular dilation. While it is believed that both heart diseases share similar pathological paths like impaired cardiac microvasculature and high oxidative stress, these deleterious effects in postpartum cardiomyopathy usually reverse within one year after delivery as compared to dilated cardiomyopathy [4]
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