Peri-partum/post-partum cardiomyopathy

Peri-partum/post-partum cardiomyopathy is a dilated cardiomyopathy that may occur in the last trimester of pregnancy through the first several months post-partum.

The pathogenesis of post-partum cardiomyopathy is uncertain, with genetic factors, sympathetic tone, hormones, and malnutrition all suggested as contributing factors to its development.

Plain radiograph
  • chest radiograph demonstrates cardiac silhouette enlargement
  • appearance is indistinguishable from other forms of dilated cardiomyopathy and the diagnosis is suggested by the patient history
  • findings of pulmonary oedema are dependent on the amount of systolic dysfunction
Echocardiography
  • can establish left ventricular systolic dysfunction
MRI
  • cine SSFP sequences can demonstrate systolic dysfunction, similarly to echocardiography
  • delayed enhancement in the left ventricular mid-myocardium has been described in the anterior and anterolateral wall 2 

The prognosis is better than in other forms of dilated cardiomyopathy, but progressive deterioration of systolic function may occur. A heart transplant may become necessary.

Gadolinium contrast is contraindicated in pregnant patients and caution should be exercised in considering its use before delivery. 

The necessary information for a presumptive diagnosis will often be possible without gadolinium contrast. Contrast may be useful for evaluation of therapeutic response postpartum, however.

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Article Information

rID: 31829
Systems: Cardiac, Chest
Section: Pathology
Synonyms or Alternate Spellings:
  • Postpartum cardiomyopathy
  • Peripartum cardiomyopathy
  • Peripartum / postpartum cardiomyopathy

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