Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy.
Sliwa K., Hilfiker-Kleiner D., Petrie MC., Mebazaa A., Pieske B., Buchmann E., Regitz-Zagrosek V., Schaufelberger M., Tavazzi L., van Veldhuisen DJ., Watkins H., Shah AJ., Seferovic PM., Elkayam U., Pankuweit S., Papp Z., Mouquet F., McMurray JJV., Heart Failure Association of the European Society of Cardiology Working Group on Peripartum Cardiomyopathy None.
Peripartum cardiomyopathy (PPCM) is a cause of pregnancy-associated heart failure. It typically develops during the last month of, and up to 6 months after, pregnancy in women without known cardiovascular disease. The present position statement offers a state-of-the-art summary of what is known about risk factors for potential pathophysiological mechanisms, clinical presentation of, and diagnosis and management of PPCM. A high index of suspicion is required for the diagnosis, as shortness of breath and ankle swelling are common in the peripartum period. Peripartum cardiomyopathy is a distinct form of cardiomyopathy, associated with a high morbidity and mortality, but also with the possibility of full recovery. Oxidative stress and the generation of a cardiotoxic subfragment of prolactin may play key roles in the pathophysiology of PPCM. In this regard, pharmacological blockade of prolactin offers the possibility of a disease-specific therapy.