Cardiomyopathy is a term used to describe damage to the heart that results in a weakened heart. The weakened heart muscle makes it difficult for the heart to pump blood efficiently and results in decreased heart function.
This in turn affects the lungs, liver and other parts of the body.
Peripartum cardiomyopathy is a rare type of cardiomyopathy that affects pregnant women during their last month of pregnancy or within 5 months of delivery. Postpartum cardiomyopathy is the term used to describe peripartum cardiomyopathy that occurs after the delivery of the child.
In the United States, the incidence of postpartum cardiomyopathy ranges from 1 in every 1,300 deliveries to 1 in every 4,000 deliveries. It can affect women of any age but usually occurs in older women after the age of 30. Women with a history of cardiac diseases such as myocarditis are at a higher risk of developing postpartum cardiomyopathy. Other risk factors for developing this disorder include obesity, smoking, heavy drinking, the use of certain medications, multiple pregnancies and malnourishment.
According to the New York Heart Association, postpartum cardiomyopathy can be classified into 4 categories depending on the severity of the symptoms exhibited.
Typical symptoms of postpartum cardiomyopathy include:
A physical examination by a doctor may reveal additional signs and symptoms such as:
Tests such as chest x-rays, chest CT scans, coronary angiography, echocardiogram and nuclear heart scan may reveal additional symptoms. These include:
One test in particular is helpful in diagnosing the underlying cause of postpartum cardiomyopathy. This is a heart biopsy. It can help in diagnosing myocarditis, a common cause of postpartum cardiomyopathy.
The exact causes of postpartum cardiomyopathy remain a mystery. Recent data shows a higher incidence of myocarditis in women with postpartum cardiomyopathy leading researchers to suspect the former as a cause. However, this conclusion is still the matter of debate.
Many medical professionals suspect that nutritional disorders can cause postpartum cardiomyopathy. However, excessive intake of salt is the only one that has been shown to increase the risk of developing this disorder.
Lower levels of the element Selenium have also been associated with postpartum cardiomyopathy.
Some studies have shown that auto-antibodies against myocardial proteins may also play a role in the development of this disorder. Preeclampsia is thought to be another cause of postpartum cardiomyopathy.
There have been reports of women from the same family developing postpartum cardiomyopathy, leading medical professionals to suspect that genetics and family history can be a cause of developing this disorder.
Treatment options for postpartum cardiomyopathy include:
In most cases, these measures are usually sufficient. However in advanced cases of postpartum cardiomyopathy where the patient does not respond satisfactorily to these treatments, the physician may have to resort to extreme measures. These include:
Other measures that are suggested to help speed recovery include:
The prognosis for women with postpartum cardiomyopathy varies. Some women remain stable for long periods and their symptoms usually subside after some time. Others can get worse either gradually or rapidly. Those who undergo a rapid deterioration in their condition are usually candidates for a heart transplant and the mortality rate in such cases may be as high as 50%.
The prognosis for women whose heart rapidly returns to its normal size after delivery is good. A heart that remains enlarged after delivery makes future pregnancies risky as it increases the chances of heart failure.