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 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Peripartum cardiomyopathy (PPCM) is a rare disorder in which left ventricular dysfunction and symptoms of heart failure occur in the peripartum period in previously healthy women. Incidence of PPCM ranges from 1 in 1300 to 1 in 15,000 pregnancies. The etiology of PPCM is unknown, but viral, autoimmune, and idiopathic causes may contribute. 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. Risk factors for PPCM include advanced maternal age, multiparity, African race, twinning, gestational hypertension, and long-term tocolysis. The clinical presentation of patients with PPCM is similar to that of patients with dilated cardiomyopathy. Early diagnosis and initiation of treatment are essential to optimize pregnancy outcome. Treatment is similar to medical therapy for other forms of dilated cardiomyopathy. About half the patients of PPCM recover without complications. The prognosis is poor in patients with persistent cardiomyopathy. Persistence of disease after 6 months indicates irreversible cardiomyopathy and portends worse survival.
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PMID:Peripartum cardiomyopathy: a comprehensive review. 1805 91

Peripartum cardiomyopathy (PPCM) affects 1000-1300 women in the United States each year. We present three cases of PPCM seen in our Emergency Department (ED) that cover the entire spectrum of disease from mild heart failure to sudden cardiac death. Without previous heart disease, these women develop cardiomyopathy with impairment of left ventricular function in the last month of pregnancy, or during the first 5 months postpartum. The etiology of PPCM is not clear, although various mechanisms have been proposed, including infection, autoimmune response, prolonged tocolysis during labor, and maladaptive responses to the hemodynamic changes of pregnancy. The initial presentation of these patients is frequently to the ED. The differential diagnosis and key characteristics of PPCM are discussed. ED management should focus on three elements: reduction in pre-load, reduction in afterload, and increase in inotropy. Key differences between the antepartum and postpartum states are highlighted.
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PMID:Emergency department evaluation and management of peripartum cardiomyopathy. 1797 13

Peripartum cardiomyopathy (PPCM) is a rare disorder in which left ventricular dysfunction and symptoms of heart failure occur in the peripartum period in previously healthy women. Incidence of PPCM ranges from 1 in 1300 to 1 in 15,000 pregnancies. The etiology of PPCM is unknown, but viral, autoimmune, and idiopathic causes may contribute. The diagnostic criteria are onset of heart failure in the last month of pregnancy or in the first 5 months postpartum, absence of determinable cause for cardiac failure, and absence of a demonstrable heart disease before the last month of pregnancy. Risk factors for PPCM include advanced maternal age, multiparity, African race, twinning, gestational hypertension, and long-term tocolysis. The clinical presentation of patients with PPCM is similar to that of patients with dilated cardiomyopathy. Echocardiography is central to diagnosis. Early diagnosis and initiation of treatment are essential to optimize pregnancy outcome. Treatment is similar to medical therapy for other forms of dilated cardiomyopathy. About half the patients of PPCM recover without complications. The prognosis is poor in patients with persistent cardiomyopathy. Persistence of disease after 6 months indicates irreversible cardiomyopathy and portends worse survival.
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PMID:[Peripartum cardiomyopathy]. 1859 37

Peripartum cardiomyopathy (PPCM) is a rare disorder, with four principal features: 1--development of cardiac heart failure in the last month of pregnancy or within five months after delivery, 2--absence of an identifiable cause for heart failure, 3--absence of underlying heart disease prior to the last month of pregnancy, 4--evidence of left ventricular systolic dysfunction by classic echocardiographic criteria. Reported forms of familial peripartum cardiomyopathy are exceptional. Our observation emphasizes the interest of cardiac magnetic resonance imaging (MRI) in the investigation of an acute heart failure occurring during the peripartum and allows us to evoke a genetic predisposition in some cases of PPCM, to discuss the fact that some forms of familial PPCM could be unknown familial dilated cardiomyopathy unmasked by pregnancy, and to wonder on the familial screening modalities.
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PMID:Can peripartum cardiomyopathy be familial? 1869 17

Peripartum cardiomyopathy (PPCM) is a serious, potentially life-threatening heart disease of unknown etiology in previously healthy women that develops between the last month of pregnancy and 5-6 months after delivery. PPCM is a distinct clinical entity in which echocardiography demonstrates the features of an idiopathic dilated cardiomyopathy with a high morbidity and mortality, but in addition, patients suffering with PPCM have a chance of reaching full recovery. A variety of potential risk factors related to PPCM have been suggested over the last decades, which may help to identify women at risk in the future. Recent advances in understanding the pathophysiology of PPCM assign a key role to unbalanced oxidative stress and the generation of a cardiotoxic prolactin subfragment. In this regard, pharmacological blockade of prolactin holds the promise of novel, more disease-specific therapy options. The present article provides an overview on the clinical appearance and management, risk factors and potential pathophysiological mechanisms of PPCM.
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PMID:Reviewing peripartum cardiomyopathy: current state of knowledge. 1937 Nov 91

Peripartum cardiomyopathy (PPCM) is a rare, but life-threatening cardiac disorder which complicates pregnancy. However, the classical symptoms of heart failure can be masked - especially in obese women. Here, we present a case report of PPCM complicated with vitamin-D deficiency in a severely obese woman.
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PMID:[Peripartum cardiomyopathy in an obese pregnant woman]. 1973 39

A 35-year-old primigravida with twin gestation was admitted for elective cesarean section. She had no preoperative systemic diseases including heart disease. At 37 weeks of gestation, elective cesarean section was performed under combined spinal-epidural anesthesia. Anesthetic course was uneventful until the delivery when the patient started to cough and complained of dyspnea. At the same time, Spo2 started to decline to reach 95% despite the oxygen supplement. Pleural effusion was observed on the chest X-ray on postoperative day 2. An echocardiography showed diffuse hypokinesis of the left ventricle with ejection fraction (EF) of 36%. Peripartum cardiomyopathy was strongly suspected. Symptoms of heart failure were alleviated by water restriction and furosemide by the 9th POD. The EF increased to 50% on the 15th POD.
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PMID:[Suspected case of peripartum cardiomyopathy developed during elective cesarean section]. 1986 Feb 31

Klippel-Trenaunay syndrome (KTS) is a rare congenital disorder of unknown etiology characterized by venous malformations or varicose veins, cutaneous capillary malformation and hypertrophy of soft tissues with limb (usually asymmetric lower extremity) involvement. Peripartum cardiomyopathy (PPCM) is characterized by rapid onset heart failure during the final month of pregnancy or within five months of delivery, in the absence of identifiable risk factors or previous heart disease. The aim of this study was to illustrate the correlation between the KTS and the onset of PPCM in women with twin pregnancies. Our case is a 35-year-old woman, gravida II para I, with KTS, twin pregnancy and PPCM. We can assume that, as the heart of a women with KTS usually works with a low preload reserve due to the widespread venous varicosities, if a significant increase in preload occurs, it may lead to the onset of cardiac dilatation and thus PPCM.
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PMID:Peripartum cardiomyopathy and Klippel-Trenaunay syndrome. 2107 13

Peripartum cardiomyopathy is a rare disorder in which heart failure occurs during the last month of pregnancy or within 5 months of delivery, in the absence of any other etiology or prior heart disease. We present the case of a 42-year-old woman with peripartum cardiomyopathy. She was admitted with an acute myocardial infarction. Multiple mobile ventricular thrombi were seen in the echocardiogram. Coronary angiogram showed consequential coronary embolus occluding the left anterior descending artery. A successful embolectomy was performed followed by coronary stenting. There have been only two reports in the medical literature of coronary embolic events in the setting of peripartum cardiomyopathy; however, to our knowledge, we believe our case is the first to describe coronary intervention as treatment for the event.
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PMID:Coronary embolus complicating peripartum cardiomyopathy. 2197 69

Peripartum cardiomyopathy is a rare cardiac disorder. Although left ventricular apical thrombus formation is common in peripartum cardiomyopathy, biventricular apical thrombi formation is a very rare condition in these patients. A 21-year-old woman presented with complaints of dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and palpitations that appeared three months after labor. Transthoracic echocardiography showed severe global hypokinesis, decreased left and right ventricular ejection fraction (left 30%, right 35%), increased left ventricular end-diastolic dimension (60 mm), grade 2 mitral regurgitation, and biventricular apical thrombi. On the second day of admission, she developed global aphasia and right hemiplegia. The patient was successfully treated with recombinant tissue plasminogen activator. Transthoracic echocardiography following treatment showed disappearance of biventricular apical thrombi. She had no neurologic deficit. Treatment for heart failure was continued due to persistence of global hypokinesis and left ventricular dilatation.
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PMID:[Development of biventricular large apical thrombi and cerebral embolism in a young woman with peripartum cardiomyopathy]. 2198 72


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