confused??????cardiomyopathy & CHF

[Patrice__0]

  Dear Sirs,
     I am a 32/f have 5 children ,on this last pregancy 6 weeks ago I started having high B.P. and pulse my child was born ok but I'm still having a rough time my EF was 10% now that I had the baby it's 20% I'm taking med,but I'm still staying tired and can't do much and the Dr. say it might get better and might not.I wondering if you could help me understand alittle more ?and will I ever be able to go shopping and in the heat again?????I have cardiomyopathy & congestive heart failure and my heart was very enlarged ,also my vert,are dialted .They was amazed that me& the baby are alive they had told my family Iwas gravely ill...and probaly wouldn't make it,,and also they are talking about a heart transplant....thank-you very much
  Patrice
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Dear Patrice,
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.
Hope this helps.  Please feel free to write back with any additional questions.
Information provided here is for educational purposes only.  It is not intended to replace your doctor's advice.  Only your doctor can make specific diagnoses and recommend treatment.  If you would like to be seen at the Cleveland Clinic please call 1-800-CCF-CARE and ask for an appointment with a cardiologist.