something is wrong...

Posted by julia on August 05, 1999 at 11:03:21
I am a 32-yr-old female, normal weight, don't smoke. I develped mild post-partum cardiomyopathy after the birth of my son, now a year old. My EF is now normal. I have mild restrictive lung disease, likely due to pectus excavatum. Questionable MVP. I continue to have chest pressure and shortness of breath. The doctors can find no physical cause, so put me on prozac and xanax, neither of which help. I do not believe this is due to anxiety. Something feels wrong and I don't know what to do next. What else can I do? Thank you, Julia

Posted by CCF CARDIO MD - CRC on August 05, 1999 at 11:06:50
I'm not sure I have an answer for why you are having these symptoms.  Anxiety is one of the possibilities but not the only one.  I have attached some additional information about post-partum cardiomyopathy for you.
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.