Post Partum Cardiomyopathy

Posted by JODY BACHIMAN on August 08, 1999 at 00:30:28
In 1989 I was diagnosed with Post Partujm Cardiomyopathy. I was 32 yo and it was my first pregnancy.  My EF was at 19% and after 2 years it was up to 50%.  I was told that was the low end of normal and that normal was in the range of 50-75%. It has stayed at 50% since then. I take 40 mg of dyaziee per day.  I now lead a normal life with normal activities, however, whenever I do any type of moderate excersise, it does take me a long time to recover. I have also noticed that I get fatigued easily and that my thighs are extremely sensitive and hurt if I get a massage or am on my feel for a long time. I believe this is a result of my cardiomyopathy. I have asked my internist about this, but could not give me an answer since it is not a common illness. Has anyone else ever experienced this and could this be a possible side effect of cariomyopathy. And, what are the normal ranges of EF for a woman in her 30's?
Posted by CCF CARDIO MD - CRC on August 09, 1999 at 08:55:52

Dear Jody,
I don't think it is a direct result of your cardiomyopathy but it may be indirect (i.e deconditioning due to the time you had the illness).  Normal EF is 50 - 60 %.  
Here is some more on peripartum cardiomyopathy.  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.  
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.