Postpartum Cardiomyopathy


What is Postpartum Cardiomyopathy?

Postpartum Cardiomyopathy is a medical term that means dilated Cardiomyopathy or the deterioration of the cardiac system between the period of the last month of the woman’s pregnancy up to or until five months the period of postpartum. It happens to pregnant women. It is a rare medical condition. Another term for Postpartum Cardiomyopathy is pregnancy associated heart failure or peripartum cardiomyopathy. Women who have Postpartum Cardiomyopathy do not necessarily have a medical history of any heart disease. Postpartum Cardiomyopathy can either be self-limiting, temporary or it can progress towards a severe and life-threatening form of heart failure.

postpartum cardiomyopathy


Image 1 – Postpartum Cardiomyopathy showing dilation of the left ventricle

According to studies conducted, the women who are African in race, older and have had multiple pregnancies are at high risk of acquiring Postpartum Cardiomyopathy. In addition to that, those pregnant postpartum women who suffered from Postpartum Cardiomyopathy are known to have left-sided ventricular problems and the group who produced a high rate of mortality. Aside from that, pregnant postpartum women who were diagnosed with Postpartum Cardiomyopathy are known to have a high risk of acquiring thrombosis.


Postpartum Cardiomyopathy Symptoms

Pregnant postpartum women who are diagnosed with Postpartum Cardiomyopathy reportedly manifest and experience the following signs and symptoms:

  • Frequency in urination
  • Fatigue that is mild in nature
  • Poor appetite
  • Cough specially at night
  • Dyspnea or difficulty in breathing episodes
  • Edema or swelling in the ankle bilaterally or both sides
  • Edema or swelling in the foot bilaterally or both sides
  • Weight gain that is excessive, especially in the last month of the period of the pregnancy
  • Wheezing
  • Abdominal pain
  • Hemoptysis or blood in the sputum
  • Pulmonary rales
  • High blood pressure upon assessment
  • Ascites especially seen in severe cases
  • Hepatomegaly or enlargement of the liver especially in severe cases
  • Orthopnea or having difficulty breathing when lying down flat in bed
  • Palpitations
  • Skipping heartbeats
  • Chest pain
  • Having long pauses in between the heartbeats
  • Paroxysmal nocturnal Dyspnea or Dyspnea during the middle of the night

Medically, the Postpartum Cardiomyopathy is a postpartum condition that affects the woman’s heart. The symptoms mentioned here are what happens to person having cardiomyopathy by itself whether it is a pregnant woman or a man.

Postpartum Cardiomyopathy Treatment

The treatment procedures done to pregnant postpartum women are similar to those who suffer from congestive heart failure or anyone who has cardiomyopathy. The following are the suggested treatments:

Initial stabilization therapy

During the initial stage of the Postpartum Cardiomyopathy, the following are provided for the pregnant postpartum woman:


  • Treatment for hypertension such as with ACE inhibitors
  • Diuretic drugs
  • Oxygenation
  • Fetal Monitoring is also started

Medical therapy

The following medications are given and prescribed to postpartum women suffering from Postpartum Cardiomyopathy:

  • Nitrate medications that function to reduce the work load of the person’s heart
  • Beta blocker medications which share the same function as nitrate medications
  • Aspirin which works to thin the person’s blood to prevent thrombosis and lower the risk of the postpartum women of having clotting of blood
  • High blood pressure medication which shares the same function as the nitrate medications
  • ACE inhibitors which aid in the work load of the person’s heart
  • Diuretic medications which works to reduce the excess amount of the fluid in the person’s body

Diet therapy: low salt diet

With regards to diet therapy, the ideal diet that she should stick to is a low salt or sodium diet. Medically speaking, when a person has an increased salt intake, it will lead to retention of fluid because salt attracts water. When this happens, the person is at risk for subsequent heart failure in persons suffering from heart ailment or disease. Postpartum women who are suffering from Postpartum Cardiomyopathy would benefit from low salt diet. They are prescribed and told to limit their sodium intake into about two grams per day.

Fluid restriction therapy

Another important treatment when it comes to postpartum women, who is suffering from Postpartum Cardiomyopathy, is to limit or restrict their fluid. Some postpartum women are unable to get rid of the excess amount of liquids found in their diet alone. When this happens, it will place a huge stress on the heart’s functional ability. Hence, there is a need to restrict fluid. The advisable fluid restriction is about 500cc or two cups or equivalent to one pound of fluid in a day or so.

General specific therapy

The following are the advised therapies for postpartum women with Postpartum Cardiomyopathy:

  • Exercise plan
  • Avoidance of alcoholic consumption as well as coffee, soft drinks and tea
  • Support stockings
  • Avoidance of fast food
  • Usage of small glasses and cups
  • Reading the labels of food prior to purchasing it
  • Avoiding seasoning or those that contain sodium such as steak sauce or soy sauce as well as monosodium glutamate, onion salt, and garlic salt
  • Intravenous fluids should be avoided as much as possible to prevent fluid overload and congestion of the heart of the postpartum women

Prognosis

When the pregnant postpartum women have been detected early with Postpartum Cardiomyopathy and given the right and proper treatment, the prognosis for that person with regards to her recovery is high.

According to the latest studies, those who were given newer conventional treatment for heart failure had a higher survival rate. Most often, those who have Postpartum Cardiomyopathy have improved with the treatments given.

The possibility of recurrence or relapse of heart failure is very minimal. Yet it is advised that those who were diagnosed with Postpartum Cardiomyopathy avoid subsequent pregnancies especially when the left ventricular function, which is usually the problem associated with Postpartum Cardiomyopathy, has not fully recovered. In sum, the prognosis of postpartum women suffering from Postpartum Cardiomyopathy is good.


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