Peripartum Cardiomyopathy


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There is no "cure" for peripartum cardiomyopathy. However, a variety of drugs are used to ease its symptoms. These can include: digoxin, heparin and ACE inhibitors like hydralazine. A low-salt diet and an exercise program can be helpful; bedrest is not usually advised. If the heart is not severely impaired and the condition is linked to the use of alcohol or some other toxic medication, sometimes the heart can return to normal if exposure to the toxic substance ends. In cases of severe peripartum cardiomyopathy, heart transplants are an option. Women with PPCM often fare well with a heart transplant because they are relatively young and have not endured a long period of heart failure (and its end-organ damage). Two-year survival rates for women with PPCM who received a transplant were 88 percent in one study. The five-year survival rate was 60 percent in a different study.

There is no way to sugarcoat the seriousness of peripartum cardiomyopathy. Its mortality rate is high, but it varies geographically. In the U.S., the reported mortality rate varies widely between 6 percent and 50 percent, with nearly half of these deaths occuring in the first three months after delivery of the baby or babies. Prognosis also appears to be related to the severity of the left ventricle dysfunction. The critical window of opportunity is the first six months after diagnosis. If a woman's heart recovers normal heart function during this period, her chances of survival improve significantly.

While these statistics are grim, peripartum cardiomyopathy is one of the few types of dilated cardiomyopathy that can be reversible.

Sources: Elkayam, Uri and Gleicher, Norbert, Cardiac Problems in Pregnancy, Third Ed., 1999, p. 97.

Lampert, Mark B., and Lang, Roberto M., "Peripartum Cardiomyopathy," American Heart Journal, 1995, Vol. 130, pp. 860-870.

Felker, G. Michael et al., "Underlying Causes and Long-Term Survival in Patients with Initially Unexplained Cardiomyopathy," New England Journal of Medicine, 2000, Vol. 342, 1077-1084.

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