Peripartum cardiomyopathy: challenges in diagnosis and management

Expert Rev Cardiovasc Ther. 2016 Sep;14(9):1035-41. doi: 10.1080/14779072.2016.1199273. Epub 2016 Jun 18.

Abstract

Introduction: Peripartum cardiomyopathy (PPCM) is one of the leading causes of maternal mortality all over the world. Fortunately, some of the most important answers to the "PPCM puzzle" are emerging:

Areas covered: This is an update that includes current and recent research results. These developments hold promise to importantly decrease mortality from PPCM and increase recovery rates. Expert commentary: Increasing risks for the development and severity of PPCM include a genetic predisposition and the presence of any form of hypertension in pregnancy. Earlier recognition/diagnosis of PPCM confers greater opportunity for full recovery. Important biomarkers have the potential to help to recognize PPCM earlier and to provide better treatment. "Follow the Guidelines" is good advice for the best opportunity to achieve full recovery. These include the use of diuretics, BB, ACEI/ARB in tolerable dosages. Phasing out specific treatments appears to be safe for some; but the process must be individualized.

Keywords: Heart failure; PPCM; biomarkers; outcomes; pregnancy; treatment.

Publication types

  • Review

MeSH terms

  • Cardiomyopathies / complications
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / therapy*
  • Diuretics / therapeutic use
  • Early Diagnosis
  • Female
  • Humans
  • Hypertension / complications
  • Peripartum Period
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis
  • Pregnancy Complications, Cardiovascular / physiopathology
  • Pregnancy Complications, Cardiovascular / therapy*
  • Puerperal Disorders / therapy

Substances

  • Diuretics