could it have been postpartum cardiomyopathy

I am concerned that I may have had PPCM following my second pregnancy and wondering what your opinion is with my symptoms.  I will give a little history.  Five years ago my daughter was born at 36 weeks due to severe preeclampsia.  I was induced as soon as my blood pressure was up.  It ranged from 140s to 160s over 90s to 110s.  Everything went fine during the delivery.  I was placed on Aldomet following her delivery.  When I arrived home, I began to feel extremely tired (feeling as though I would fall asleep at any moment) and more swelling in my feet and ankles (I was already swollen due to the pregnancy).  I also felt as though my heart was enlarged (this might sound crazy, but it did) and I also had a very slow heart rate (40s to 50s).  My blood pressure remained elevated with at least one time reaching 190/120.  Also, I do not recall feeling short of breath postpartum, although I was during the pregnancy, which I assumed was normal due to the pregnancy.  I do not recall these symptoms lasting very long, maybe 2 weeks at max.  Eventually, everything returned normal and I was weaned off the Aldomet when my pressures began to reach normal levels (apprx 1 to 2 months postpartum).

Two years ago, (3 years after delivery) while at an annual checkup, my doctor noticed a 1/6 murmur and sent me for an echocardiogram.  This was basically normal with an EF of 65% and with trace mitral and tricuspid regurgitation.  Everything else was normal.

I want to have another child, but am afraid that this might have been PPCM.  I have mentioned this to my OB doctor and he looked over my echocardiogram and listened to my heart and heard no murmur.  He told me that my symptoms were common with use of Aldomet and not to worry.  I still do though.

My questions then are:  Are these symptoms consistent wtih Aldomet use?  Is there anyway to know if I did have PPCM without having an echo back then?  

Thank you very much for your insight into this.  I am very nervous about attempting another pregnancy with this thought in my mind.  

[threeboys]

HI...
I do have PPCM, and I also had preeclamsia with it. Part of the reason it went a week with out being diagnosed was the factthat my preeclmsia was so bad I had to have an emergency c-sect at 35 weeks. When my kidney began to fail and my symptoms didn't subdise they looked at everything. finally a week later of still being in the hospital and not  being able to walk or breathI was diagnosed, they coded my room and my O2 levels were in the 70's. I was diagnosed with it then. My EF was 20% and now 7 rs later it is 45%.

My suggestion to you is look further into it. Get your ECHO reports, even though you recovered doesn't mean you didn't have it. Esp with the preeclamsia you had. There is an awesome website that is strictly for PPCM and womwn wanting to have more children there is also a DOC on it and he is able to answer all the question. If you would like it, pls e-mail me.

I think it does warrent futher investigations, but it may just be that you are watched by a cardio, with your OB. There a many people on theboard who have gone on tohave more children and are pg now.

A lot of women do recover in the first 6 weeks to 6 months, so it is could be the case with you.

Having said that, it may have been the meds. Did they ever do a BNP test??

amy
if you want my e-mail, I'll give it too you.

[threeboys]

I'll give you my e-mail...I'm not sure I'm allowed to post it.
amy
amyskrobisatyahoodotcom
just put the reg stuff instead of the words. :)

[beck94]

I had no other testing done at that time.  The only test I had was the echocardiogram 3 years later.  I would love that website you mentioned.  Thanks for your response!

becca

[KLB32]

Wow...I've never even heard of PPMC.  I have high BP and had to switch from an ACE inhibitor to a beta blocker before trying to get PG 6 years ago.  I was placed on Aldomet as well and it was awful.  My BP was actually higher on the Aldomet than it was if I took no BP meds!  I mean really high...like close to the reading you had.  I felt really awful on it, too.

If your echo came back normal and your OB/GYN and Cardio think you'll be ok this time around, I would go for it.  Just because you had pre-eclampsia with the last pg doesn't necessarily mean you'll have it again this time.  Talk to your Dr. about other BP drugs that are safe during pg besides Aldomet in the event it does happen again.  I took Labetalol (beta blocker) and hydrochlorothiazide(diuretic) during my entire pg and my daughter is perfectly fine.  My BP was also really well controlled.

Good luck to you!