Peripartum Cardiomyopathy: Definition, Symptoms & Causes

Instructor: Artem Cheprasov
This lesson defines a condition known as peripartum cardiomyopathy (PPCM). You'll learn what happens with the heart during this condition, its signs and symptoms, and potential causes.

Peripartum Cardiomyopathy

It wasn't all that long ago that giving birth was a very risky and sometimes fatal endeavor. It still has its risks; however, even in developed nations. One of those risks is peripartum cardiomyopathy. Peripartum cardiomyopathy refers to a form of heart disease that involves heart failure as a result of the dysfunction of the left ventricle during systole when there is no other identifiable cause of heart disease. This happens either towards the end of pregnancy, usually during the last month, or within about 5 months after delivery.

Let's learn more about this condition, its causes, signs, and symptoms.

More on the Definition

As the definition stated, peripartum cardiomyopathy (PPCM) is a form of heart failure. This implies the heart is unable to pump enough blood into general circulation to meet the body's demands for oxygenated blood. In PPCM, this heart failure occurs as a result of the dysfunction of the left ventricle during systole. The left ventricle is the chamber of the heart that pumps blood from the heart and into general (body) circulation. Systole is the phase of the heart pumping cycle where the heart muscle squeezes to push blood forward.

In PPCM, the left ventricle is unable to pump enough blood out into the body. In fact, the heart only pumps less than 45% of the amount of blood in the left ventricle with every heartbeat. Normally, the left ventricle should pump out 50%-55% or more of the blood it contains with every heartbeat.

Causes

The cause of peripartum cardiomyopathy is unknown. Some suspect that numerous factors contribute to its occurrence, including:

  • Infections
  • Nutritional issues
  • Genetics
  • Hormonal imbalances
  • Autoimmune processes, where the body's immune system attacks itself

PPCM is a diagnosis of exclusion as well. Meaning, other causes of the woman's signs and symptoms have been ruled out prior to diagnosing her with PPCM.

Signs & Symptoms

What are the signs and symptoms? Well, a woman with PPCM may have any of the following:

  • Cough, including a bloody cough
  • Dyspnea: difficulty breathing, especially if active, lying down or at night
  • Angina: chest pain
  • Abdominal pain
  • Increased frequency of nighttime urination
  • Fatigue
  • Swollen neck veins
  • Palpitations and irregular heartbeats
  • Dizziness
  • Sudden changes in swelling of the legs or arms
  • A fast heart beat

The problem is, some of these signs and symptoms are found during normal pregnancy, so diagnosis of PPCM is often delayed as a result. Almost half of the diagnoses for PPCM took a week or more to establish. Thus, a clinician will need to be on the lookout for the new or rapid onset of signs and symptoms or the worsening of some of the existing signs and symptoms in order to be alerted to the fact that the woman may have PPCM.

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