Peripartum cardiomyopathy: still unknown. The current state of knowledge

Abstract

Peripartum cardiomyopathy (PPCM) is defined as idiopathic cardiomyopathy which occurs at the end of pregnancy or in the first few months after delivery, with symptoms of heart failure (HF) secondary to left ventricular dysfunction, and at the same time no other cause for this condition. The pathomechanism of the disease has not yet been fully understood, but it is probably based on the interaction of complex factors. The clinical course of PPCM varies from life-threatening acute heart failure to mild symptoms mimicking the symptoms typical of the perinatal period. In Europe, PPCM is a rare disease but there are areas of the world where it occurs in one in every 300 cases. The treatment of PPCM is similar to that of HF with reduced ejection fraction. However, it is important to exclude drugs with teratogenic effects during pregnancy. The inclusion of bromocriptine in PPCM therapy seems to be justified, and in some cases improves the prognosis.