Peripartum cardiomyopathy Flashcards
1
Q
What is the definition of peripartum cardiomyopathy?
A
heart failure at the end of pregnancy or in the months following delivery
2
Q
What are the risk factors for peripartum cardiomyopathy?
A
- multiparity
- afro-caribbean
- advanced maternal age
- hypertension
- multiple pregnancy
3
Q
What is the presentation of peripartum cardiomyopathy?
A
- dyspnea
- reduced exercise tolerance
- palpitations
- pulmonary or peripheral edema
- symptoms relating to peripheral or cerebral emboli
Signs
- tachycardia
- tachypnea
- pulmonary edema
- congestive cardiac failure
- dysrhythmias
4
Q
How is peripartum cardiomyopathy diagnosed?
A
- clinical features of heart failure
- ECHO: ejection fraction <45%, heart is enlarged with global dilation of all chambers
- chest x-ray: cardiomegaly
- elevated troponin 1 & BNP
5
Q
How is peripartum cardiomyopathy managed?
A
- ICU: supportive care
- Stabalization of scute failure: oxygen, diuretics, digoxin, vasodilators, beta blockers, ACEI after delivery
- elective delivery (if antenatal)
- Anticoagulation with LMWH
6
Q
What is the prognosis post partum?
A
- 50% make a spontaneous & full recovery
- contraception should be advised
