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Cardiomyopathy after pregnancy
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Cardiomyopathy after pregnancy

  I am 25 yrs. old. I had my last son in Feb. of 1995 and was diagnosed with cm in November of 1996. I also have mvp and aortic valve reguration. The latest echo. showed no signs of cm. I was put on Lanoxin, Mavik and Indural for about 18 months for the cm. I changed drs. and the new one found no signs of cm and took me off all my meds. in March of '98. I have been doing good since but do have a question. Could my mvp or aortic valve problems caused the cm? I was advised not to have anymore children because the drs. said the cm was brought on by pregnancy. And could I get cm more easily since I've already had it? I go to the dr. once a year for a check-up and the latest exam was good. Thanks, Kelly
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Dear Kelly,

Post-Partum (or peripartum) cardiomyopathy is a relatively rare form of heart failure that affects women during or following pregnancy.  Establishing a diagnosis requires 1. The absence of a determinable cause for cardiac failure, 2. Absence of preexisting heart muscle disease, and 3. Time limitations of onset of illness from the last month of pregnancy to the first 5 post-partum months.  Peripartum cardiomyopathy complicates 1 of 1300 to 4000 deliveries in the United States.  This condition may affect women of any race, age, or number of prior deliveries; however, older, multigravida, African American and twin pregnancies are thought to represent predisposing features.  The cause is unknown.   I doubt the mvp or aortic valve problems are contributing to your problems because if they were it would not be reversible.
The treatment is standard heart failure medication (diuretics, digoxin, ACE inhibitors) and in severe cases heart transplant.  Approximately half of patients with this diagnosis will return to normal within 6 months.  Of those who do not return to normal the prognosis is poor with an average survival of 4.7 years after diagnosis (without transplant).  Repeat pregnancies are not recommended for women who have had peripartum cardiomyopathy.  You can find additional information in the following articles.  (your local medical library should be able to help you find these).
Lampert, MB Lang RM. Peripartum cardiomyopathy. Am Heart J 1995; 130:860-870.
Huerta EM, Erice A, Espino RF, et al. Postpartum cardiomyopathy and acute myocarditis. Am Heart J 1985; 110:1079-1081.
I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.





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