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Peripartum Cardiomyopathy: Definition, Incidence, Etiopathogenesis, Diagnosis and Management.
MedLine Citation:
PMID:  25111318     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early post-partum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally-accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Due to recent data demonstrating deterioration of left ventricular systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of left ventricular function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of peripartum cardiomyopathy.
Authors:
Jalaj Garg; Chandrasekar Palaniswamy; Gregg Lanier
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-8
Journal Detail:
Title:  Cardiology in review     Volume:  -     ISSN:  1538-4683     ISO Abbreviation:  Cardiol Rev     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9304686     Medline TA:  Cardiol Rev     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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