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What the doctor needs to know - case studies

Some important information you need to know about Peripartum Cardiomyopathy.

Heart Failure (HF)

Symptoms associated with Peripartum Cardiomyopathy

Diagnostic tools

ECG and NT-proBNP & BNP can be used as a screening tool for PPCM. However, for the definitive diagnosis and monitoring of this disease echocardiography or MRI is necessary. Routine screening is not recommended at present. However, patients presenting with new onset fatigue, shortness of breath or other signs of heart failure should be screened.

Case studies

Left bundle branch block during pregnancy as a sign of imminent peripartum cardiomyopathy
European Heart Journal 2010
Saida Labidi, Denise Hilfiker-Kleiner, and Gunnar Klein

Bromocriptine treatment associated with recovery from peripartum cardiomyopathy in siblings: two case reports
Journal of Medical Case Reports 2010
Gerd Peter Meyer, Saida Labidid, Edith Podewski, Karen Sliwa, Helmut Drexler, Denise Hilfiker-Kleiner

Recovery From Postpartum Cardiomyopathy in 2 Patients by Blocking Prolactin Release With Bromocriptine
Journal of the American College of Cardiology 2007
Denise Hilfiker-Kleiner, Gerd Peter Meyer, Elisabeth Schieffer, Britta Goldmann, Edith Podewski, Ingrid Struman, Philipp Fischer, Helmut Drexler

Patient management

Medication: Standard therapy for heart failure including ACE-inhibitors and beta-blockers for at least 1 year. Thereafter, in patients with fully recovered function, controlled reduction of medication may be possible. However, no data on the outcome of patients stopping therapy is available. 

Contraception:  Further pregnancies should be avoided because of risk of recurrence. Some heart failure medications such as ACE-inhibitors and angiotensin receptor blockers may affect embryonic and foetal development.

Subsequent pregnancies: A general risk of relapse is observed. A 50% mortality in patients with an ejection fraction of less than 35% at onset of subsequent pregnancy has been reported.