Peripartum cardiomyopathy: when labour turns to heartbreak

SUMMARY
The association between heart failure and pregnancy was described in 1850 by Ritchie,⁽¹⁾ but it was first described as a distinct clinical pathological entity by Gouley in 1937.⁽²⁾ In 1971, the term ‘peripartum cardiomyopathy’ (PPCM) was coined by Demakis,⁽³⁾ who defined the diagnostic criteria that was later adapted for use by the National Heart Lung and Blood Institute (NHLBI). The four criteria for defining PPCM recommended by the NHLBI include: (a) the development of cardiac failure in the last month of pregnancy or within five months of delivery; (b) the absence of an identifiable cause of cardiac failure; (c) the absence of a recognisable heart disease prior to the last month of pregnancy; and (d) left ventricular systolic dysfunction demonstrated by echocardiographic criteria such as depressed left ventricular ejection fraction.⁽⁴⁾ Although the aetiology of PPCM is unclear, a recent study has suggested that antiangiogenic factors produced at the final stage of pregnancy may be related to  this condition.⁽⁵⁾

 

Singapore Med J 2013; 54:1-2; http://dx.doi.org/10.11622/smedj.2013001