Peripartum Cardiomyopathy

Circulation. 2016 Apr 5;133(14):1397-409. doi: 10.1161/CIRCULATIONAHA.115.020491.

Abstract

Peripartum cardiomyopathy is a potentially life-threatening pregnancy-associated disease that typically arises in the peripartum period and is marked by left ventricular dysfunction and heart failure. The disease is relatively uncommon, but its incidence is rising. Women often recover cardiac function, but long-lasting morbidity and mortality are not infrequent. Management of peripartum cardiomyopathy is largely limited to the same neurohormonal antagonists used in other forms of cardiomyopathy, and no proven disease-specific therapies exist yet. Research in the past decade has suggested that peripartum cardiomyopathy is caused by vascular dysfunction, triggered by late-gestational maternal hormones. Most recently, information has also indicated that many cases of peripartum cardiomyopathy have genetic underpinnings. We review here the known epidemiology, clinical presentation, and management of peripartum cardiomyopathy, as well as the current knowledge of the pathophysiology of the disease.

Keywords: cardiomyopathies; heart failure; pre-eclampsia; pregnancy.

Publication types

  • Review

MeSH terms

  • Bromocriptine / therapeutic use
  • Cardiomyopathies* / diagnosis
  • Cardiomyopathies* / epidemiology
  • Cardiomyopathies* / etiology
  • Cardiomyopathies* / therapy
  • Cardiovascular Agents / therapeutic use
  • Disease Susceptibility
  • Female
  • Heart Failure / etiology
  • Heart Transplantation
  • Hormones / blood
  • Humans
  • Hypertension / complications
  • Incidence
  • Infant, Newborn
  • Lactation / drug effects
  • Pre-Eclampsia / physiopathology
  • Pregnancy
  • Pregnancy Complications, Cardiovascular* / diagnosis
  • Pregnancy Complications, Cardiovascular* / epidemiology
  • Pregnancy Complications, Cardiovascular* / etiology
  • Pregnancy Complications, Cardiovascular* / therapy
  • Pregnancy, Multiple
  • Puerperal Disorders* / diagnosis
  • Puerperal Disorders* / epidemiology
  • Puerperal Disorders* / etiology
  • Puerperal Disorders* / therapy

Substances

  • Cardiovascular Agents
  • Hormones
  • Bromocriptine