Cardiomyopathy, Peripartum

Cardiomyopathy, Peripartum is a topic covered in the 5-Minute Emergency Consult.

To view the entire topic, please or purchase a subscription.

Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:

Emergency Central

-- The first section of this topic is shown below --

Basics

Description

  • Dilated cardiomyopathy occurring during the last month of pregnancy up to 5 mo following the delivery
  • Diagnostic criteria (all required):
    • Onset of myocardial failure during last month of pregnancy or 1st 5 mo after delivery
    • Absence of a specific cause
    • Absence of prior cardiac disease
  • Diagnosis requires strict criteria of echocardiographic dysfunction
  • Incidence: 3–5/10,000 live births
  • ∼50% of cases resolve spontaneously
  • Mortality: 18–56%
  • Risk factors:
    • Older women (>30 yr)
    • Multiparous women
    • Multiple gestations
    • Prolonged tocolytic therapy (>4 wk)
    • Obesity
    • Preeclampsia
    • African American
  • Systemic and pulmonary embolism more frequent than with other forms of cardiomyopathy
  • Factors indicating a poor prognosis:
    • Lower left ejection fraction at 6 mo postpartum
    • Onset >2 wk postpartum
    • Age >30 yr
    • African American descent
    • Multiparity

Etiology

Various causes are suggested but remain unproved:
  • Viral infection leading to myocarditis in presence of immunosuppression during pregnancy (most likely)
  • Immunologic response to an unknown maternal or fetal antigen
  • Maladaptive response to the hemodynamic stresses of pregnancy
  • Stress-activated cytokines
  • Prolonged tocolysis
  • Selenium deficiency

-- To view the remaining sections of this topic, please or purchase a subscription --

Citation

* When formatting your citation, note that all book, journal, and database titles should be italicized* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Cardiomyopathy, Peripartum ID - 307525 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307525/all/Cardiomyopathy__Peripartum ER -