User:Mr. Ibrahem/Peripartum cardiomyopathy

Peripartum cardiomyopathy (PPCM) is a type of dilated cardiomyopathy which presents between the last month of pregnancy and five months after deliver. Symptoms are those of heart failure, with shortness of breath, tiredness, and swelling. Other symptoms may include palpitations, chest pain, or dry cough. Onset may be gradual or sudden. Complications can include arrhythmias, blood clots, fetal distress, and sudden death.

The cause is unknown, and previously healthy women can be affected. Risk factors include hypertensive disorders of pregnancy, multiple gestations, and family history. The underlying mechanism involves systolic dysfunction of the heart resulting in decreased left ventricular ejection fraction (EF) typically below 45%. Diagnosis is based on symptoms and a heart ultrasound; after ruling out other possible causes.

Delivery in a timely manner may be recommended. Before delivery, treatments may include beta-blockers, thiazide diuretics, or furosemide. After delivery, management is similar to typical heart failure. An implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) may be another option; though an external device may be used as over half improve over six month. Recovery may require five years; with a risk of death of 7 to 50%. There is a risk it may recur in future pregnancies, and thus these may be recommended against.

Peripartum cardiomyopathy affected about 1 in 2,200 pregnancies in the United States, with rates as high as 1 in 300 in Haiti. Those over the age of 25 or 30 years are more commonly affected. Being African is also a risk. The condition was first defined in 1971 by Demakis; though, had been recognized since the 1700s.