|
Peripartum cardiomyopathy Causes and Risks:
Peripartum cardiomyopathy is a form of dilated cardiomyopathy caused by current pregnancy or delivery within the last 4 months.
The disorder affects approximately 4 out of 10,000 women. It may occur at ages 18 to 41 but it is most common after age 30. Other risk factors include obesity , having a personal or family history of cardiac disorders such as myocarditis , use of certain medications, smoking , alcoholism , multiple pregnancies, being black, and being malnourished.
Cardiomyopathy occurs when there is damage to the heart with muscle degeneration and scarring (fibrosis).
Symptoms may develop more rapidly than other cardiomyopathies and include the symptoms of heart failure .
Prevention:
Modify controllable risk factors. Eat a generally well-balanced, nutritious diet, exercise to increase cardiovascular fitness, and avoid or minimize smoking and consumption of alcohol.
Symptoms:
Signs and Tests:
Examination by touch ( palpation ) and tapping with the fingers ( percussion ) indicate enlargement of the heart , and may indicate fluid in the lungs. Examination by listening to the chest with a stethoscope ( auscultation ) reveals lung crackles, heart murmur, or other abnormal sounds. The liver may be enlarged and neck veins may be distended. Blood pressure may be low or may drop when rising to a standing position (orthostatic hypotension ).
Heart enlargement, congestion of the lungs or the veins in the lungs, decreased cardiac output, decreased movement or functioning of the heart, or heart failure may show on: An ECG shows conduction disturbances, arrhythmias such as atrial fibrillation , ventricular tachycardia , or an ectopic heartbeat (premature or abnormal beat), and enlargement of the ventricles of the heart.
A heart biopsy may be helpful to distinguish an underlying cause of the cardiomyopathy . Lab tests may vary.
Treatment:
Hospitalization may be required until acute symptoms subside. There is no cure: treatment focuses on relieving the symptoms.
Medications include digitalis or other cardiac medications to strengthen the heartbeat, and diuretics to remove excess fluid. A low-salt diet may be recommended. Fluid may be restricted in some cases. Activity may be restricted when symptoms develop.
Daily weighing may be recommended. A weight gain of 3 or 4 pounds or more over 1 or 2 days may indicate fluid accumulation.
If you smoke or drink alcohol, stop. These habits may make the symptoms worse.
A heart transplant may be considered if heart function is very poor.
Prognosis:
The outcome varies but death rate in some series has been as high as 25 to 50%. Some people remain stable for long periods, some deteriorate gradually, and some deteriorate rapidly. The probable outcome is improved in those whose heart size returns to normal after the postpartum period. If the heart remains dilated (enlarged), future pregnancy may result in progression of the heart disease . The woman with peripartum cardiomyopathy may be a candidate for a heart transplant .
Complications:
Call Your Healthcare Provider:
Call your health care provider if you are currently or recently pregnant and symptoms indicate cardiomyopathy may be developing.
Call your health care provider if chest pain , palpitations , faintness , or other new or unexplained symptoms develop.
|
