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CONTROVERSIAL ISSUES IN THE MANAGEMENT OF PREGNANT WOMEN WITH HEART DISEASE: Heart Failure |
PREGNANCY ASSOCIATED CARDIOMYOPATHY |
Peripartum Cardiomyopathy Definition NIH Workshop Recommendations and Review 1997, Pearson et al, JAMA 2000; 283:1183 |
Peripartum Cardiomyopathy Incidence |
Peripartum Cardiomyopathy Limitations of NIH Definition |
Pregnancy-Associated Cardiomyopathy Data Collection (n=123) |
PPCM – Time of Diagnosis N=123 |
Patient Population (Traditional Diagnosis) |
Patient Population (Early Diagnosis) |
Comparison between Traditionally and Early diagnosed PPCM patients. |
Peripartum Cardiomyopathy Clinical Profile in the U.S. |
PERIPARTUM CARDIOMYOPATHY (pregnancy associated cardiomyopathy) DEFINITION |
periartum Cardiomyopathy Clinical Presentation |
PERIPARTUM CARDIOMYOPATHY Thromboembolism |
PPCM MATERNAL OUTCOME |
Outcome in 123 Patients With PACM |
LONG-TERM SURVIVAL IN PTS WITH INITIALLY UNEXPLAINED CARDIOMYOPATHY (Felker et al NEJM 2000;342:1077) |
PPCM - Mortality |
PPCM – INTERVAL FROM END OF PREGNANCY TO DEATH Whitehead et al. Am J Obstet Gynecol 2003;102:1326 |
Maternal Outcomes |
Left Ventricular Ejection Fraction in 52 Patients with Complete Set of Measurements |
PREDICTORS OF RECOVERY OF LV FUNCTION |
PPCM - Predictors of recovery of LV function (Mody, Elkayam et al. Circulation in press) |
peripartum Cardiomyopathy Reported associated conditions |
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PPCM and Pentoxifylline 6 Month Mortality |
PPCM and Pentoxifylline Combined Endpoint of Poor Outcome (Death, Class III-IV @ last FU, Failure to increase EF >10%) |
PPCM SUBSEQUENT PREGNANCY |
PPCM Subsequent Pregnancy |
Outcome of Subsequent Pregnancies in PPCM (Elkayam et al NEJM 2001;344:1567) |
Maternal Complications in women without abortions |
Outcome of Subsequent Pregnancies in Women With PPCM (Elkayam U, Eur Heart J 2002) |
PPCM RISK OF SUBSEQUENT PREGNANCY |
PPCM RISK OF SUBSEQUENT PREGNANCY |
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Anomalous origin of the left main cor. Art. from pulm. trunk masquerading as PPCM |
Postpartum Onset of Acute HF Due to Autoimmune Myocarditis |
Peripartum Cardiomyopathy Treatment |
Peripartum Cardiomyopathy Treatment of severe HF |
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Peripartum Cardiomyopathy Witlin et al, Am J Obstet Gynecol 1997; 176:182 |
Peripartum Cardiomyopathy (JAMA, 2000;283:1183-1186) |
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The Outcome of Subsequent Pregnancies in Women With PPCM (Elkayam et al NEJM 2001;344:1567) |
Peripartum Cardiomyopathy Etiology |
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The Outcome of Subsequent Pregnancies in Women With PPCM (Elkayam et al NEJM May 2001) |
Peripartum Cardiomyopathy Modified Criteria |
The Outcome of Subsequent Pregnancies in Women With PPCM (Elkayam et al NEJM May 2001) |
The Outcome of Subsequent Pregnancies in Women With PPCM (Elkayam et al NEJM 2001;344:1567) |
The Outcome of Subsequent Pregnancies in Women With PPCM (Elkayam et al NEJM 2001;344:1567) |
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Peripartum Cardiomyopathy |
Peripartum Cardiomyopathy |
Peripartum Cardiomyopathy Predictors of Outcome Sliwa et al, JACC 2000;35:701 |
Peripartum Cardiomyopathy Etiology |
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Mode of Delivery |
Peripartum Cardiomyopathy Etiology |
IS TOCOLYTIC THERAPY A RISK FACTOR FOR PPCM? |
Peripartum Cardiomyopathy Etiology |
PPCM and Incessant Atrial Tachycardia Brito et al, Revista Portug Cardiol 1997;16:157 |
PPCM and Incessant Atrial Tachycardia Brito et al, Revista Portug Cardiol 1997;16:157 |
PPCM and Incessant Atrial Tachycardia Brito et al, Revista Portug Cardiol 1997;16:157 |
PPCM and Incessant Atrial Tachycardia Brito et al, Revista Portug Cardiol 1997;16:157 |
Prevalence, Mortality and Morbidity of PPCM Mielniczuk et al, Circulation 2004;110:520 |