Document Detail


Peripartum cardiomyopathy: current understanding, comprehensive management review and new developments.
MedLine Citation:
PMID:  20935342     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Peripartum cardiomyopathy (PPCM) is a rare and potentially fatal disease which presents with symptoms of heart failure primarily due to left ventricular (LV) systolic dysfunction in the last month of pregnancy and up to 5-6 months after delivery. PPCM is still regarded as a disease of unknown aetiology, although recent evidence suggests a role for a 16 kDa prolactin derivative produced by proteolytic cleavage of prolactin secondary to unbalanced oxidative stress present during late pregnancy and early puerperium. The medical management of PPCM is similar to other forms of non-ischaemic dilated cardiomyopathy, but with the management tailored to choose safe drugs in pregnancy and lactation to minimise maternal and fetal morbidity. There is an increased risk of venous thromboembolism, and anticoagulation is recommended. About 30-50% of the patients recover without complications, with their baseline LV systolic function at rest returning to normal. The risk of recurrence of PPCM is high, especially if the LV systolic function has not fully recovered. However, for those women who have normal LV systolic function as demonstrated on echocardiography and dobutamine stress test, the risk of severe cardiomyopathy including death is relatively low in a subsequent pregnancy.
Authors:
Jason R Pyatt; Gopal Dubey
Publication Detail:
Type:  Journal Article     Date:  2010-10-10
Journal Detail:
Title:  Postgraduate medical journal     Volume:  87     ISSN:  1469-0756     ISO Abbreviation:  Postgrad Med J     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0234135     Medline TA:  Postgrad Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  34-9     Citation Subset:  IM    
Affiliation:
Consultant Cardiologist, Cardiology Department, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Prescot Street, Liverpool L7 8XP, UK. jason.pyatt@rlbuht.nhs.uk.
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