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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Peripartum cardiomyopathy is a rare manifestation of heart disease which accounts for less than 1% of the cardiovascular problems associated to pregnancy, with a variable incidence of myocarditis ranging from 29 to 100%. We present a patient with peripartum cardiomyopathy in whom endomyocardial biopsy was normal, but the studies with anti-myosin antibodies suggested the presence of myocarditis. Clinical signs and controversies between anatomopathologic and isotopic studies are discussed.
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PMID:[Peripartum cardiomyopathy with normal endomyocardial biopsy and positive antimyosin-In 111 study for myocarditis]. 156 49

Peripartum cardiomyopathy is a rare form of heart disease with a high mortality rate. We report a case, refractory to intensive medical treatment, with a fatal issue 5 months post partum. In recent years the literature has provided examples of the beneficial effect of immunosuppressive therapy, either Azathioprine combined with prednisone, or prednisone alone.
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PMID:Peripartum cardiomyopathy. 343 54

Pregnancy causes substantial changes in the cardiovascular system: cardiac output (40%-50%) and blood volume (40%) increase whereas systemic peripheral resistance and arterial pressure decrease. The rise in progesterone and estrogen levels accompanying pregnancy stimulates the renin-angiotensin-aldosterone system. Increased prostaglandin production follows renin activation; simultaneously, the arterial vessels show diminished angiotensin sensitivity. The result is pronounced vasodilatation. Cardiovascular diseases remain the most important nonobstetric cause of maternal death. The physiological changes in the cardiovascular system during pregnancy influence cardiac diseases in different ways. Pregnancy, labor, and delivery appear to be well tolerated in gravidae with an atrial septal defect, ventricular septal defect, and patent ductus arteriosus. Sometimes congestive heart failure occurs and appropriate medical therapy is necessary. Pregnant women with uncorrected cyanotic congenital heart disease (Eisenmenger's syndrome, tetralogy of Fallot) constitute a high-risk group because of right ventricular insufficiency and hypoxic attacks. The consequences for anaesthesia in parturients with congenital heart disease are discussed. The symptoms of acquired mitral or aortic stenosis are aggravated by the physiological changes in the cardiovascular system during pregnancy; the clinical symptoms of valve insufficiency are ameliorated by vasodilatation. Peripartum cardiomyopathy clinically shows similar features to idiopathic dilated cardiomyopathy. The basis of treatment is the same as that of congestive heart failure, with the therapeutic spectrum ranging from diet to heart transplantation. Women with hypertrophic cardiomyopathy tolerate pregnancy, labor, and delivery surprisingly well. Vaginal delivery is possible, but epidural anaesthesia is contraindicated. Hypertensive disorders associated with pregnancy are classified into three groups: chronic, transient, and pre-eclamptic hypertension. Whereas chronic and transient hypertension do not affect the outcome of pregnancy appreciably, pre-eclampsia presents a potential danger to mother and fetus. Pre-eclamptic hypertension is accompanied by low cardiac output and plasma volume. An upregulation of angiotensin receptors enhances vascular reactivity, with the consequence of high peripheral resistance. For antihypertensive therapy hydralazine, alpha-methyldopa, and magnesium sulfate are the drugs of choice. A generalised recommendation of anaesthesia for the pre-eclamptic gravida cannot be made because both general and epidural anaesthesia have risks of severe side effects.
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PMID:[Cardiovascular diseases during pregnancy. Considerations for the anesthesiologist]. 765 90

Peripartum cardiomyopathy is defined as a syndrome of cardiac failure occurring in the latter part of pregnancy or in the puerperium without obvious cause and without prior evidence of heart disease. Analysis of the particular features of this syndrome and a review of the literature indicate its similarity with other cardiomyopathies in terms of clinical features, natural history and treatment, but maternal and fetal prognosis is poor.
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PMID:[Peripartum cardiomyopathy. Analysis of 3 cases and review of the literature]. 850 1

Peripartum cardiomyopathy is a classic but uncommon entity in African women about which there is little etiologic understanding. From January 1990 to March 1996 a series of 30 cases of peripartum cardiomyopathy was collected at the Principal Hospital in Dakar, Senegal. Peripartum cardiomyopathy was defined as the occurrence of cardiac insufficiency in a woman with no previous history of heart disease, during the period between the second and twentieth weeks after delivery confirmed by ultrasound evidence of dilated cardiomyopathy. The overall incidence of peripartum cardiomyopathy during the study period was 30 out of 1200 deliveries. The mean age of the women in the study was 34 years and mean parity was 5.2. In 13.3% of cases births involved twins. There were no predisposing socio-economic or climatic factors. The clinical picture was severe cardiac failure in 80.3% of cases and left ventricular insufficiency in 16.6%. In all cases ultrasound findings were typical of dilated cardiomyopathy. Serum selenium and vitamin B1 levels were normal. Measurements of T CD4 and CD8 in eight patients were normal. Conversion enzyme inhibitors were administered to twenty patients. Complete remission was achieved in 14 patients, three patients died, and thirteen patients presented ultrasonic evidence of persistent dilated cardiomyopathy. One patient relapsed after a subsequent delivery. These findings are in agreement with previous reports concerning the clinical and prognostic features of peripartum cardiomyopathy in Africa.
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PMID:[Etiopathogenic, ultrasonographic and prognostic features of postpartum cardiomyopathy]. 913 97

Peripartum cardiomyopathy (PPCM) is an uncommon myocardial disease arising in the latter part of pregnancy or during the first five postpartum months, in the absence of any obvious cause and with no previously known heart disease. The risk of recurrence of PPCM is considered low when left ventricular size and function return to normal: We illustrate a case of peripartum cardiomyopathy recurred in subsequent pregnancy despite the rapid return to normal of heart size and function.
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PMID:Recurrent peripartum cardiomyopathy. 948 42

Peripartum cardiomyopathy (PPCM) is a rare form of heart failure affecting women in the last month of pregnancy or the first six months post-partum. The etiology of PPCM remains poorly understood although some risk factors were described. Diagnosis is often difficult and is always necessary to exclude other prior heart disease and other cause of left ventricular dysfunction in pregnancy. Medical therapy for PPCM is similar to that for other forms of congestive heart failure; prognosis is better than in idiopathic cardiomyopathy but many authors observed that women who have had one episode of PPCM are likely to have recurrences in subsequent pregnancies. The present report describes the case of a woman presenting with severe cardiac failure immediately after cesarean section for twin pregnancy. The patient is a 35-year-old nulliparous white woman, with history of anorexia, subsequent amenorrhea, sterility and pregnancy induced with Gn-Rh. The diagnosis of PPCM was difficult for the presence of preeclampsia and acute pulmonary edema occurred four hours after delivery. The successful outcome was possible with an intensive treatment (mechanical ventilation, Swan-Ganz catheter). The whole resolution of the heart failure, six months post-partum, was demonstrated by ultrasonography.
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PMID:[Peripartum dilatative cardiomyopathy. Case report with literature review]. 1052 39

Peripartum cardiomyopathy in the form of congestive heart disease of unknown etiology appears relatively rarely during the last month of pregnancy or within 5 months after delivery, and it is potentially life-threatening. This case report describes a 34-year-old female, G4P1, at 36 weeks' gestation who was admitted for cesarean section under lumbar epidural anesthesia due to twin pregnancy. She had no past history of cardiovascular diseases. However, rapid onset of dyspnea at ward and acute cardiac failure developed 15 h after cesarean section. Peripartum cardiomyopathy was diagnosed. After a 7-day intensive treatment she was discharged. Since then she was symptom-free and her two babies were doing well during a period of one more years after discharge.
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PMID:Peripartum cardiomyopathy--a case report. 1140 96

Peripartum cardiomyopathy is an under-recognized form of dilated cardiomyopathy of unknown cause and is associated with excess morbidity and mortality in women of childbearing age. Incidence of peripartum cardiomyopathy ranges from 1 in 1,300 to 1 in 15,000 pregnancies. The diagnostic criteria are onset of heart failure in the last month of pregnancy or in first 5 months postpartum, absence of determinable cause for cardiac failure, and absence of a demonstrable heart disease before the last month of pregnancy. Multiparity, twin births, advanced maternal age, preeclampsia, gestational hypertension, and black race are known risk factors. The exact cause of peripartum cardiomyopathy is unclear. The clinical presentation of patients with peripartum cardiomyopathy is similar to that of patients with systolic congestive heart failure. Little is known about the therapy of this disease, and the medical treatment is limited to the use of drugs for symptomatic control. Prospective, randomized, double-blind studies are needed to define the role of immunosuppressive treatment and to evaluate the role of conventional treatment of dilated cardiomyopathy in reducing the mortality rate of peripartum cardiomyopathy. About half the patients of peripartum cardiomyopathy recover without any complications. The prognosis is poor in patients with persistent cardiomyopathy. Persistence of disease after 6 months indicates irreversible cardiomyopathy and portends worse survival. The risk of developing peripartum cardiomyopathy in subsequent pregnancies remains high. The clinical and therapeutic aspects of the peripartum cardiomyopathy are discussed.
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PMID:Peripartum cardiomyopathy: clinical and therapeutic aspects. 1171 28

Peripartum cardiomyopathy is a rare, potentially life-threatening cardiomyopathy of unknown cause. Diagnosis includes clinical (development of cardiac failure in the last month of pregnancy or within 5 months after delivery, absence of an identifiable cause of cardiac failure and absence of recognizable heart disease prior to the last month of pregnancy) and echographic (left ventricular systolic dysfunction) criteria. Therapy is standard, except for angiotensin converting enzyme inhibitors, which should be avoided at the end of pregnancy, and heart transplantation if medical treatment fails. We report the case of a 24 year-old woman who required left ventricular assistance as a bridge before cardiac transplantation.
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PMID:[Peripartum cardiomyopathy]. 1172 86


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