Peripartum cardiomyopathy

There is an excellent article in the Cleveland Clinic Journal of Medicine on peripartum cardiomyopathy, and it is definitely worth knowing a bit about this. Though not commonly asked (probably because the condition is rare), you never know!!...

Key points

• Occurs in last trimester or up to 5 months after delivery (ESC definition)
• Can be due to myocarditis, inflammation, viral infections (parvovirus B19, HHV-6)
• Risk factors
• Advanced maternal age
• Multiparity
• Gestational hypertension / pre-ecclampsia
• Symptoms are that of heart failure

Diagnostic criteria

• Heart failure in the last trimester or within 5 months of delivery, without other causes of heart failure identified and no previous heart disease
• Reduced ejection fraction < 45%

Diagnosis

• Echocardiogram
• Cardiac MRI

Treatment

• AVOID ACE inhibitors and ARBs during pregnancy. They can be used in post partum period
• Digoxin
• Spironolactone
• Beta blockers.

That's just a brief overview. For the purposes of the MRCP , remember the diagnostic criteria, and the drugs to avoid.

Read the full article here. Enjoy doctors!