Management of peripartum cardiomyopathy.

Peripartum cardiomyopathy (PPCM) is a form of heart failure that occurs in women within 1 month of predelivery and 5 months postdelivery. Echocardiography demonstrates features of cardiomyopathy with impaired ejection fraction; global dilatation and thinned-out walls are sometimes present. The symptoms and signs of PPCM are similar to those in patients with idiopathic dilated cardiomyopathy. The acute form of PPCM is a clinical syndrome, with reduced cardiac output, tissue hypoperfusion, and increase in the pulmonary capillary wedge pressure. Monitoring of the patient with the acute form of PPCM should be initiated as soon as possible. The types and levels of monitoring required for an individual patient vary widely depending on the severity of the cardiac decompensation and response to initial therapy. The syndrome carries a high morbidity and mortality, and diagnosis is often delayed. This review summarizes recent data charting the incidence, recent advances in the understanding of the pathophysiology of PPCM, and outlines the current treatment options available.