UMEM Educational Pearls

Category: Cardiology

Title: Peripartum cardiomyopathy part II

Keywords: peripartum cardiomypathy, cardiomyopathy (PubMed Search)

Posted: 5/20/2012 by Amal Mattu, MD
Click here to contact Amal Mattu, MD

[This week's cardiology pearl provided by Dr. Semhar Tewelde]

PPCM is diagnosed  by echocardiography and increasingly confirmed and complemented with cardiac MRI after the ddx has been ruled-out i.e. pregnancy associated myocardial infarction, valvular heart disease, unrecognized congenital heart disease, hypertensive emergency, amniotic fluid or pulmonary embolism, or pre-eclampsia
PPCM has no histological classification and the role of routine endomyocardial biopsy (EMB) is controversial and remains unclear
Tx includes management of acute heart failure: non-invasive ventilatory/mechanical ventilation, diuretics, vasodilators (nitroglycerine/nitroprusside), inotropes (dobutamine/milrinone), pressors (dopamine), heparin, mechanical circulatory support (IABP, ECMO, LVAD), and finally cardiac transplant 
PPCM has a mortality rate as high as 30%



Blauwet LA, Cooper LT. Diagnosis and management of peripartum cardiomyopathy.
Heart. 97(23):1970-81, 2011 Dec.