Peripartum Cardiomyopathy

Causes & Risk Factors for PPCM

The cause of peripartum cardiomyopathy is unknown. Some studies suggest it may be linked to the overactivity of certain hormones that damage the vascular system. Genetics or family history may also play a role, but more research is needed.

There are several risk factors that may increase a woman’s chance of developing PPCM, including:

• Being of African American descent
• Maternal age of 35 or older
• History of multiple pregnancies
• History of multiple gestations (twins or triplets)
• History of gestational hypertension or preeclampsia
• Obesity
• Smoking
• Alcohol abuse
• Poor nutrition

Symptoms of Peripartum Cardiomyopathy

A diagnosis of PPCM might be considered if a woman is in the final weeks of pregnancy or has recently given birth and has any of the following symptoms:

• Bloating
• Chest pain or tightness
• Coughing
• Fatigue
• Heart palpitations
• Increased urination at night
• Lightheadedness or fainting
• Nausea
• Shortness of breath
• Swelling in the legs and abdomen

Pregnant women and those who have recently given birth, should seek immediate medical evaluation if they experience any of the symptoms listed above.

How Is Peripartum Cardiomyopathy Diagnosed?

PPCM can be challenging to diagnose because many of the symptoms of heart failure can also be caused by pregnancy, including shortness of breath and swelling of the legs and ankles. If a healthcare provider suspects PPCM, the following diagnostic tests will be performed:

• Physical exam to look for signs of fluid in the lungs, rapid heart rate or abnormal heart sounds
• Echocardiogram to evaluate the heart’s motion, blood flow and pumping efficiency of the ventricles.
• Lab tests to assess kidney, liver and thyroid function
• Complete blood count (CBC) to check for anemia or evidence of infection
• Other blood tests to evaluate for cardiac injury

If no other cause for the heart failure symptoms can be found, a diagnosis of PPCM may be confirmed.

Personalized Treatment Plans for PPCM

The goal of peripartum cardiomyopathy treatment is to improve maternal heart function and prevent fluid from collecting in the lungs or other parts of the body. All treatments are carefully considered to protect the baby if the mother is still pregnant or breastfeeding. Treatments may include:

• Medication to treat symptoms and help restore heart function. Examples of potential drug therapies include ACE inhibitors, beta blockers, diuretics, anticoagulants and other medications to strengthen the pumping ability of the heart.
• Low-salt diet.
• Fluid restrictions.
• Daily weight monitoring. A weight gain of three pounds or more in a day or two may signal fluid buildup.

Women who smoke and/or drink alcohol are strongly advised to stop as these habits can worsen the condition and harm both mother and baby. With treatment, many women with PPCM will recover normal heart function within three to six months. In rare cases, however, the condition can lead to severe heart failure, requiring mechanical heart pumps or a heart transplant.