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[pearl provided by Dr. Semhar Tewelde]
Peripartum cardiomyopathy (PPCM) is a relatively rare idiopathic form of heart failure that occurs during the last months of pregnancy or the first months after delivery
By definition, the LV ejection fraction (LVEF) is generally <45% and dilated
LV diastolic assessment often reveals a restrictive pattern, indicating elevated LV filling pressure
Risk factors associated with PPCM include multiparity, twin pregnancy, extremes of reproductive age, and prolonged tocolysis
The most common presenting symptoms in PPCM include dyspnea, peripheral edema, and fatigue
The ECG typically demonstrate sinus rhythm or sinus tachycardia
Left bundle branch block develops in up to 50% of cases and based on studies on long term outcomes in patients with systolic heart failure, may serve as a predictor of mortality
References
Blauwet LA, Cooper LT. Diagnosis and management of peripartum cardiomyopathy.
Heart. 97(23):1970-81, 2011 Dec.