Washington Manual of Medical Therapeutics
Peripartum Cardiomyopathy
General Principles
Definition
Peripartum cardiomyopathy (PPCM) is defined as LV systolic dysfunction diagnosed in the last month of pregnancy up to 5 months postpartum, with an incidence 1 in 1000–4000 pregnancies in the United States.1
Etiology
The exact etiology of PPCM remains unclear. There is evidence to support viral, nutritional, and autoimmune contributors. Animal model and epidemiologic data suggest that vascular dysfunction and toxicity incited by the peripartum hormonal environment plays a central role in PPCM.2,3,4
Risk Factors
Risk factors that predispose a woman to PPCM include advanced maternal age, multiparity, multiple pregnancies, preeclampsia, and gestational hypertension. There is a higher risk in African-American women, but this may be confounded by the higher prevalence of hypertension in this population.
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