Peripartum cardiomyopathy is a rare type of heart failure that occurs during pregnancy or immediately after delivery. The damage weakens the heart muscle and causes the heart to become enlarged. As a result, the heart can’t pump blood properly throughout the rest of the body.
According to the Cardiovascular Research Foundation, this heart condition affects about one in every 3,000 to 4,000 women each year. Women are diagnosed during the last month of their pregnancies or within five months of delivery (CRF).
Certain pre-pregnancy factors can increase your risk of developing this condition. Quick medical attention is crucial to prevent further complications.
Causes and Risk Factors
Your heart pumps up to 50 percent more blood during pregnancy in order to transfer oxygen and vital nutrients to your growing baby. There is no definitive cause of peripartum cardiomyopathy. However, doctors believe this condition occurs when the extra pumping of blood is combined with other risk factors. This combination places additional stress on the heart.
According to the National Institutes of Health (NIH), a variety of risk factors can increase your chances of developing this condition, including:
- high blood pressure
- personal history of heart disease including myocarditis (inflammation of the heart muscle)
- African American descent
- multiple pregnancies
- being over the age of 30
- premature delivery medications (NIH, 2012)
Symptoms of peripartum cardiomyopathy are similar to symptoms of heart failure. You may experience:
- rapid heartbeat or palpitations
- chest pain
- excessive fatigue
- tiredness during physical activity
- shortness of breath
- swelling of feet and ankles
- increased urination at night
Your doctor will review your symptoms and perform a physical exam. They may use a device called a stethoscope on your chest. This instrument helps the doctor listen for crackling noises in the lungs as well as abnormal sounds within the heart. Your doctor will also test your blood pressure. Your blood pressure may be lower than normal, or it may drop significantly when you stand up.
A variety of imaging tests are used to measure your heart. Such tests also determine the rate of blood flow. Some of these imaging exams are also used to view potential lung damage. Possible tests may include:
- X-ray of the entire chest
- computed tomography (CT) scan for detailed pictures of the heart
- nuclear heart scan to show heart chambers
- sound waves to create moving pictures of the heart (echocardiogram)
The exact form of treatment your doctor recommends depends on the severity of your condition. Peripartum cardiomyopathy doesn’t have a cure, and the heart damage is irreversible. Women who develop this condition are hospitalized until symptoms are controlled.
A heart transplant or use of a balloon heart pump are recommended in severe cases. For most women, however, treatment involves managing and reducing symptoms.
Your doctor may prescribe the following medications to control your symptoms:
- beta blockers: drugs that reduce blood pressure and improve blood flow by blocking the hormone adrenaline
- digitalis: drugs that strengthen the heart to improve pumping and circulation
- diuretics: drugs that lower blood pressure by removing excess water and salt from the body
Women with this condition may also be advised to follow a low-salt diet to manage their blood pressure. Alcohol and tobacco products should be avoided entirely, as they can aggravate symptoms.
Peripartum cardiomyopathy can affect your health for the rest of your life, even after successful treatment. Follow through with regular check-ups and take all medications as directed.
Severe complications include:
- blood clots, particularly in the lungs
- congestive heart failure
The outlook for this condition depends on the severity and time frame of your condition. Women who develop the condition during pregnancy have a better chance of their hearts returning to normal size after delivery. Survival rates are better in these cases.
Other women don’t fare as well and get worse quickly. The National Institutes of Health estimate that 25 to 50 percent of women with this condition eventually die from it (NIH, 2012). The course of the disease varies. It can progress slowly in some women and rapidly in others. A heart transplant is the best way to preserve longevity.
Certain lifestyle habits can decrease your risk. This is especially important for first-time mothers. Focus on:
- regular exercise
- a low-fat diet
- avoiding cigarettes
- avoiding alcohol
Women who have been diagnosed with peripartum cardiomyopathy are at risk for developing the condition with future pregnancies. In these cases, women may consider taking birth control to prevent pregnancy altogether.