Peripartum cardiomyopathy: A review.
Rev Port Cardiol
; 42(11): 917-924, 2023 11.
Article
en En, Pt
| MEDLINE
| ID: mdl-37414337
ABSTRACT
Peripartum cardiomyopathy is a rare type of heart failure manifesting towards the end of pregnancy or in the months following delivery, in the absence of any other cause of heart failure. There is a wide range of incidence across countries reflecting different population demographics, uncertainty over definitions and under-reporting. Race, ethnicity, multiparity and advanced maternal age are considered important risk factors for the disease. Its etiopathogenesis is incompletely understood and is likely multifactorial, including hemodynamic stresses of pregnancy, vasculo-hormonal factors, inflammation, immunology and genetics. Affected women present with heart failure secondary to reduced left ventricular systolic function (LVEF <45%) and often with associated phenotypes such as LV dilatation, biatrial dilatation, reduced systolic function, impaired diastolic function, and increased pulmonary pressure. Electrocardiography, echocardiography, magnetic resonance imaging, endomyocardial biopsy, and certain blood biomarkers aid in diagnosis and management. Treatment for peripartum cardiomyopathy depends on the stage of pregnancy or postpartum, disease severity and whether the woman is breastfeeding. It includes standard pharmacological therapies for heart failure, within the safety restrictions for pregnancy and lactation. Targeted therapies such as bromocriptine have shown promise in early, small studies, with large definitive trials currently underway. Failure of medical interventions may require mechanical support and transplantation in severe cases. Peripartum cardiomyopathy carries a high mortality rate of up to 10% and a high risk of relapse in subsequent pregnancies, but over half of women present normalization of LV function within a year of diagnosis.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
Problema de salud:
2_mortalidade_materna
/
6_cardiovascular_diseases
/
6_other_circulatory_diseases
Asunto principal:
Complicaciones Cardiovasculares del Embarazo
/
Trastornos Puerperales
/
Insuficiencia Cardíaca
/
Cardiomiopatías
Tipo de estudio:
Risk_factors_studies
Límite:
Female
/
Humans
/
Pregnancy
Idioma:
En
/
Pt
Revista:
Rev Port Cardiol
Asunto de la revista:
CARDIOLOGIA
Año:
2023
Tipo del documento:
Article
País de afiliación:
India