Peripartum Cardiomyopathy: The Dangerous Heart Condition New Moms Should Understand

It sounds like a fictional story. An otherwise healthy expectant mother is diagnosed with a heart condition that could be fatal, mere days before giving birth. This isn’t fiction, though. Peripartum cardiomyopathy (PPCM) affects more than 1,000 women in the U.S. each year. PPCM is a little-known yet sometimes fatal form of cardiac disease, in which the heart muscle thins and weakens late in pregnancy and following childbirth.

Some estimates say about 10 percent of women with PPCM die from the disease and over half have a weakened heart muscle for the rest of their lives. The cause of peripartum cardiomyopathy is still unknown.

What is peripartum cardiomyopathy?

If PPCM is so terrifying, why don’t we hear more about it? Not knowing what causes it makes it harder to educate expectant mothers and their support circles.

“PPCM is a weakness of heart muscle and decrease in heart function associated with pregnancy,” says Dr. Zeeshan Khan, an interventional cardiologist.

The weakness on the left side of the heart, known as the left ventricle, causes inflammation and the heart becomes enlarged. In this state, the heart cannot effectively pump enough blood through the cardiovascular system to get the rest of the organs what they need.

Heart failure causes other organs to fail and within minutes the body gives out. Without immediate treatment women may die.

How do you know it’s PPCM?

Another frightening factor when dealing with PPCM is the point when it appears during pregnancy. “Patients usually present symptoms during the third trimester and up to five months after delivery,” Dr. Khan says.

Unfortunately, the symptoms for detecting the heart defect are similar to normal living conditions for a pregnant woman during her last weeks of pregnancy, as well as after giving birth.

“Patients present with typical features of heart failure like shortness of breath, difficulty in lying flat and lower extremity swelling," says Dr. Khan. “All of which can be similar to symptoms of normal pregnancy.”

From the American Heart Association, symptoms of the condition include:

• Fatigue
• Feeling of heart racing or skipping beats (palpitations)
• Increased nighttime urination
• Shortness of breath with activity and when lying flat
• Swelling of the ankles
• Swollen neck veins
• Low blood pressure, or it may drop when standing up.

Symptoms may be hard to separate from healthy levels of fatigue, but if you believe what you’re feeling is abnormal, don’t hesitate to get checked out.

How is PPCM treated?

If no other causes of heart failure are identified, PPCM is diagnosed using an echocardiogram and treatment begins.

“Treatment of PPCM includes medications that improve heart function,” Dr. Khan says. “Some of these medications interfere with child development and should be used only with direction from your doctor. There is a high risk of cardiomyopathy during subsequent pregnancies and it is important to consider these risks and discuss this with your cardiologist and obstetrician.”

The medications used for PPCM are similar to those used for any type of heart failure and are meant to reduce fluid around the lungs to allow the heart to heal as much as possible. Commonly used medications are listed below.

Angiotensin converting enzymes, or ACE inhibitors – allows for lower blood pressure

Beta blockers –treats issues with heart rhythm in addition to lowering blood pressure

Diuretics – increases the amount of water and salt released as urine from the body to relieve fluid build-up around the heart

Digitalis – helps strengthen the heart and allows it to work harder to avoid heart failure

Anticoagulants – thins the blood and allows it to flow more easily and not clot

Using proper medication, many women return to normal heart function. However, sometimes the condition continues to worsen until additional mechanical support is needed or a heart transplant is required.

Women who are pregnant or could be in the future can reduce the risk of PPCM by exercising regularly to strengthen the heart. Additional steps to building a strong heart include eating a heart-healthy diet as well as avoiding cigarettes and alcohol.

More tips for a healthy pregnancy

Our blog is full of information for expectant mothers. Do you have sciatic nerve pain or worry if getting vaccinated while pregnant can affect your baby? If you are concerned about your pregnancy or are simply looking for a new doctor, the INTEGRIS website can help you.