Peripartum cardiomyopathy (PPCM), also called postpartum cardiomyopathy, is a rare type of heart failure. It occurs in the late stages of pregnancy or up to 5 months after giving birth.
A person’s heart is responsible for pumping blood around the body. If the individual experiences heart failure, the organ cannot pump blood properly.
The American Heart Association (AHA) estimates that around
Read on to learn more about PPCM, including its treatments, symptoms, and possible complications.
PPCM is a
A person’s heart comprises
- the left atrium
- the right atrium
- the left ventricle
- the right ventricle
The atria, which are the heart’s upper chambers, receive blood from the veins. The ventricles, the lower chambers, pump blood out into the body.
PPCM weakens the pumping chambers of the heart. This causes its muscles to become thinner, meaning it cannot contract normally. If the heart cannot contract properly, it cannot pump enough blood around the body.
PPCM can be difficult to diagnose, as some symptoms are
A doctor will perform a physical exam to check for signs of PPCM. During this exam, they will use a stethoscope to check for:
- fluid in the lungs
- crackling sounds from the lungs
- a rapid heart rate
- unexpected noises from the heart
A doctor may also request an echocardiogram, an ultrasound of the heart. By using an echocardiogram, they can look at the structure of this organ. This helps them check for anything unexpected or heart function issues.
The doctor may also use laboratory tests to check:
- liver, kidney, and thyroid function
- electrolytes, chemicals that regulate nerve and muscle function
- signs of anemia or infection
- for evidence of cardiac injury or stress
According to the AHA, a person will receive a diagnosis of PPCM if they meet the following three
- The heart is less able to pump due to left ventricular dysfunction. The left ventricle of the heart is in charge of pumping oxygen-rich blood around a person’s body. If the left ventricle becomes enlarged, it can pump less blood. The amount of blood that the left ventricle pumps is called the ejection fraction (EF), which is typically between 55% and 70%. If a person has PPCM, their EF is less than 45%.
- Heart failure has developed in the last month of pregnancy or up to 5 months following delivery.
- There is no other cause for the person’s heart failure.
PPCM treatment aims to prevent fluid buildup in the lungs and help the heart recover. A doctor can prescribe the following
- angiotensin-converting enzyme inhibitors, which help improve blood flow
- beta-blockers, which lower heart rate
- diuretics, which reduce fluid retention
- digitalis, which strengthens the pumping ability of the heart
- anticoagulants, which help prevent blood clots
sodium-glucose transport protein 2 inhibitors
- angiotensin receptor blockers
- angiotensin receptor-neprilysin inhibitors
However, some of these medications are not safe for a developing fetus or baby when the parent is nursing, so individuals need to discuss the risks and benefits with a healthcare professional.
Doctors may also recommend lifestyle changes to treat PPCM, such as:
A doctor may also suggest that a person weighs themselves daily. An increase of 3–4 pounds or more over 1–2 days may signal fluid retention.
Symptoms of PPCM can
- palpitations, which might feel like the heart is racing or has skipped a beat
- increased nighttime urination
- shortness of breath during activity or when lying flat
- swollen ankles
- swollen neck veins
- low blood pressure
- blood pressure that lowers when standing up
- exercise intolerance
Health experts commonly use the New York Heart Association classification to categorize heart failure symptoms in the following way:
- Class I: Disease with no symptoms
- Class II: Mild symptoms or symptoms with extreme exhaustion
- Class III: Symptoms with minimal exertion
- Class IV: Symptoms during rest
The exact cause of PPCM is currently unclear. The
The AHA suggests the following as potential causes for PPCM:
- not following a nutritious diet
- small-vessel disease, a condition that affects the small blood vessels of the heart
- coronary artery spasm
- issues with the body’s antioxidant defenses, which help prevent cell damage
- pregnancy-related factors such as preeclampsia and hormonal influences on the heart
Certain risk factors may increase a person’s chances of developing PPCM,
- having obesity
- a history of heart problems, such as inflammation of the heart muscle
- using certain medications
- having multiple pregnancies
- not following a nutritious diet
- high blood pressure
- autoimmune disease
- substance misuse
- thyroid dysfunction
A study from 2020 found that 50% of PPCM cases occur in women over 30 years of age. However, the condition can affect individuals of varying age groups.
Ethnic and racial disparities
Cardiovascular disease is the
In 2017, the American College of Cardiology reported data that researchers collected over 30 years. It showed that African American women presented with more severe cases of PPCM than non-African American women. They also recovered less frequently, and when they did recover, it took them twice as long as non-African American women.
Research from 2021 suggests that
According to a 2020 article, recovery and mortality rates vary significantly based on racial groups, geographical region, and the definition of recovery.
PPCM can lead to
A person who has had PPCM can still have more children. However, doctors may advise them against further pregnancies if their EF
If an individual with PPCM wishes to have more children, they should discuss the risks and benefits with their cardiologist.
If a person wants to
An individual may also wish to speak with a doctor about their risk of developing PPCM. A healthcare professional may suggest ways to reduce certain risk factors for the condition.
If a person notices symptoms of PPCM, they should speak with a doctor as soon as possible. PPCM can be fatal, so individuals need swift diagnosis and treatment.
A person should also speak with a healthcare professional if they develop any concerning symptoms during pregnancy.
PPCM is a form of heart failure that develops in late pregnancy or up to 5 months after pregnancy.
Doctors diagnose PPCM when a person has an EF of less than 50% and there is no other cause for heart failure. Once healthcare professionals diagnose PPCM, they can prescribe various medications to treat the condition.
There are certain risk factors for PPCM. A person may reduce their chances of developing the condition with several lifestyle changes.
The outlook for individuals with PPCM is good. However, PPCM can be a fatal condition, so people should undergo treatment as soon as possible.
An individual with PPCM can also consider having more children, although doctors may advise against it.