Practical management of peripartum cardiomyopathy.
- Author:
Mi Jeong KIM
1
;
Mi Seung SHIN
Author Information
- Publication Type:Review
- Keywords: Peripartum cardiomyopathy; Cardiomyopathies; Pregnancy; Heart failure
- MeSH: Cardiomyopathies*; Diagnosis; Female; Heart Failure; Heart Failure, Systolic; Humans; Oxidative Stress; Peripartum Period*; Postnatal Care; Pregnancy; Prognosis; Prolactin; Ventricular Dysfunction, Left
- From:The Korean Journal of Internal Medicine 2017;32(3):393-403
- CountryRepublic of Korea
- Language:English
- Abstract: Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy that causes systolic heart failure (HF) in previously healthy young women. Despite latest remarkable achievement, unifying pathophysiologic mechanism is not well established. Considering close temporal relationship to pregnancy, the recent prolactin theory is promising. Abnormal short form of 16-kDa prolactin may be produced in the oxidative stress milieu, show anti-angiogenic effect and damage cardiovascular structure in late pregnancy. Future study is needed to determine whether abnormal prolactin system is useful as a biomarker for diagnosis and therapy of PPCM. Diagnosis is made based on the finding of left ventricular systolic dysfunction after excluding other causes of HF. A multidisciplinary team approach is essential for acute HF, antepartum, labor and postpartum care. Recovery from left ventricular dysfunction is critical for prognosis. As PPCM can recur and cause serious clinical events, subsequent pregnancy is not recommended. This review focuses on the practical management of PPCM.
