Re: Peripartum Cardiomyopathy

Posted By CCF CARDIO MD - MTR on March 10, 1998 at 13:46:28:

In Reply to: Peripartum Cardiomyopathy posted by Jamie Shombert on March 04, 1998 at 11:41:18:







: I am a 28 year old female. I was found to have Postpartum Cardiomyopathy in
Dec 1997. They accidently found this when doing an echo for my arryhthmia.
I have no syptoms (symptoms) at all of Cardiomyopathy. By way of an EPS study they
found that the arryhthmia is not caused by the slight elargement of the left
Ventrical. The arryhthmia is in the right ventrical. I had 3 weeks of high
blood pressure at the end of my pregnancy. The enlargement is discribed as
"minamal". I was place on Coreg and Coumadin and as a very prudent step a
sodium restriction. I still feel totally healthy. So with all this in mind.
What are the stats on peripartum partients? When I see that 1/3 recover,
does this mean they go on to live normal life expectancies? I am just very
confused by the "stats" because I know they included all ages and extremes
of this diease. I was just wondering if there were brighter words for a
postpartum CM patient. Thank you ever so much for your time and energy.
                                                            Jamie






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Dear Jamie, thank you for your question.  Postpartum or peripartum cardiomyopathy
is a disorder that rarely occurs in women in their third trimester of pregnancy or
in the six months postpartum. We don't know why this disorder happens but usually,
women have dilation and dysfunction of the four cardiac chambers (atria and ventricles)
and congestive heart failure.  About 50-60% of the patients recover within 6 months while
the remaining patients develop progressive heart failure.  Most women with this disorder
are symptomatic with heart failure (shortness of breath, ankle swelling, fatigue) and
are diagnosed when their symptoms lead them to a physician for an evaluation.  It sounds
like you had an arrhythmia (abnormal heart rhythym) that lead to your diagnostic work-up.
Your echocardiogram showed only mild right ventricular enlargement which would be against
the diagnosis of postpartum cardiomyopathy where all cardiac chambers are enlarged.  
Additionally, arrhythmias without heart failure are uncommon in this disorder.  I wonder
if you have another condition that might be mistaken for postpartum cardiomyopathy.  
The right ventricle can develop fatty infiltration of the walls, fibrosis, or enlargment
that leads, in turn, to arrhythmias from the disordered musculature of the right ventricle.
This disorder is called arrhythmogenic right ventricular dysplasia (ARVD) and may be
present in your case.  I suggest that you go over your diagnosis with your cardiologist
to better delineate what's going on.  It's difficult to predict what your prognosis is
going to be at this point.  However, if you do have postpartum cardiomyopathy, your
medications sound appropriate and you might be cautioned to avoid future pregnancies.  These
issues need to be addressed by your own physicians.  I hope this information helps.
Information provided in the heart forum is for general purposes only.  Specific diagnoses
and therapies can only be provided by your physician.