Peripartum cardiomyopathy is a rare disorder in which a weakened heart is diagnosed within the final month of pregnancy or within 5 months after delivery.

Cardiomyopathy occurs when there is damage to the heart. As a result, the heart muscle becomes weak and cannot pump blood efficiently. Decreased heart function affects the lungs, liver, and other body systems.

Peripartum cardiomyopathy is a form of dilated cardiomyopathy in which no other cause of heart dysfunction (weakened heart) can be identified.

In the United States, peripartum cardiomyopathy complicates 1 in every 1,300 - 4,000 deliveries. It may occur in childbearing women of any age, but it is most common after age 30.

Risk factors include obesity, having a personal history of cardiac disorders such as myocarditis, use of certain medications, smoking, alcoholism, multiple pregnancies, being African-American, and being malnourished.

• Shortness of breath
  • On exertion
  • When lying flat (orthopnea)
• Fatigue
• Swelling of the ankles
• Increased night-time urination (nocturia)
• Feeling of racing heart or skipping beats (palpitations)

During a physical examination, the physician will look for signs of fluid in the lungs by touching and tapping with the fingers. Listening to the chest with a stethoscope will reveal lung crackles, a rapid heart rate, or abnormal heart sounds.

The liver may be enlarged and neck veins may be swollen. Blood pressure may be low or may drop when the patient stands up.

Heart enlargement, congestion of the lungs or the veins in the lungs, decreased cardiac output, decreased movement or functioning of the heart, or heart failure may show on:

• Echocardiogram
• Chest x-ray
• Chest CT scan
• Coronary angiography
• Nuclear heart scan (MUGA, RNV)

An ECG can show enlargement of the heart; problems with the electrical part of the heart, called conduction disturbances; and arrhythmias, such as atrial fibrillation, ventricular tachycardia, or an ectopic heartbeat (premature or abnormal beat). A heart biopsy may be helpful in determining an underlying cause of cardiomyopathy.

Many cases of peripartum cardiomyopathy seem to be related to myocarditis, which can be confirmed by a heart biopsy.