Re: Peripartum cardiomyopathy a few questions!

Posted By CCF CARDIO MD - CRC on September 30, 1998 at 10:23:01:

In Reply to: Peripartum cardiomyopathy a few questions! posted by Brenda on September 28, 1998 at 19:17:16:






: I was diagnosed about 4 weeks ago, and am on Prinivil 7.5mg twice a day, coumiden and lasix,
:  
: 1st)My original cardioligist started me on coreg 3.125 twice a day, I was on it for a week when he referred me to a CHF clinic at a local university, they said to stop taking the Coreg for now, why would you think?
:  
:  2nd) I've been having some weaking in my legs is this some side effect from meds? My ef is 15-20%.  
3rd) What are most accurrate tests to do for the heart?  I heard a heart cath, I've had an echo, and am know scheduled for a MUGA,and in what order would you say is best for someone of my age(31)?       Thanks soo much,love,Brenda



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:Can you also tell if there's blockage from a Muga scan?  Also I heard that Coreg can decrese  the progression of this disease? or is that still up for debet?  Thanks again Brenda
Thank you for your questions.  
Q:My original cardioligist started me on coreg 3.125 twice a day, I was on it for a week when he referred me to a CHF clinic at a local university, they said to stop taking the Coreg for now, why would you think?
A: Coreg is a beta blocker that is used for patients with cardiomyopathy.  The timing of starting and stopping this medication will vary widely depending upon the individual patient and their current symptoms.
Q: I've been having some weakness in my legs is this some side effect from meds?
A: Sometimes it is difficult to differentiate side effects from the underlying effects of the cardiomyopathy.  Thus it could be due to either and the best way to deal with this is to discuss your symptoms with your doctor.
Q: What are most accurrate tests to do for the heart?
A: This depends upon what you are looking for.  A heart cath will demonstrate blockages in the arteries which may not be necessary for you.  Echo looks at not only the ejection fraction but the valve function as well.  MUGA also looks at ejection fraction and is a highly reproducible test.
Hope this helps.  Feel free to write back with any additional questions.

Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist






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Dear Brenda,
Thank you for your question.  

Q: Can you also tell if there's blockage from a Muga scan?
A: No.  A MUGA scan only determines ejection fraction.  It may be done with a thallium scan which can detect blockages.
Q: Also I heard that Coreg can decrease the progression of this disease?
A:  This may be true but has yet to be proven.
Hope this information helps.  I have also attached some additional information below. Feel free to write back with any additional questions.

Information provided here is for general educational purposes only. Only your doctor can provide specific diagnoses and treatments. If you would like to be seen at the Cleveland Clinic, please Call 1 - 800 - CCF - CARE for an appointment at Desk F15 with a cardiologist.

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.