Early diagnosis of pregnancy-associated heart disease linked to better outcomes

(University of Pennsylvania School of Medicine) Women who are diagnosed with peripartum cardiomyopathy (PPCM) during late pregnancy or within a month following delivery are more likely to experience restored cardiac function and improved outcomes compared to those who are diagnosed later in the postpartum period, according to a new study. The findings underscore the need for increased awareness and monitoring of heart failure symptoms, particularly among black women, who, on average, are diagnosed significantly later than white patients, researchers found.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news

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Peripartum cardiomyopathy (PPCM) is a potentially life ‐threatening condition typically presenting as heart failure with reduced ejection fraction (HFrEF) in the last month of pregnancy or in the months following delivery in women without another known cause of heart failure. This updated position statement summarizes the knowledge about pathophysiolo gical mechanisms, risk factors, clinical presentation, diagnosis and management of PPCM. As shortness of breath, fatigue and leg oedema are common in the peripartum period, a high index of suspicion is required to not miss the diagnosis. Measurement of natriuretic peptides,...
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Position Paper Source Type: research
Diagnostic criteria for peripartum cardiomyopathy are: Development of heart failure in the last month of pregnancy or within 5 months after delivery Left ventricular systolic dysfunction with ejection fraction less than 45% No other identifiable cause for heart failure No recognized heart disease before the last month of pregnancy Reference van Spaendonck-Zwarts KY1, van Tintelen JP, van Veldhuisen DJ, van der Werf R, Jongbloed JD, Paulus WJ, Dooijes D, van den Berg MP. Peripartum cardiomyopathy as a part of familial dilated cardiomyopathy. Circulation. 2010 May 25;121(20):2169-75.
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology Source Type: blogs
Authors: Isogai T, Kamiya CA Abstract Peripartum cardiomyopathy (PPCM) is a specific cardiomyopathy in which heart failure develops due to reduced myocardial contraction during pregnancy or in the postpartum period in women without a previous history of heart disease. The epidemiology of PPCM has been reported in various countries and areas, and the incidence of PPCM differed among these reports. The incidence was highest (1 in 102 deliveries) in Nigeria and lowest (1 in 15,533 births) in Japan. The incidence was higher in African-Americans than in other races in several reports from the United States, and was also...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
Authors: Westhoff-Bleck M, Hilfiker-Kleiner D, Pankuweit S, Schieffer B Abstract Pregnancy-associated diseases of the cardiovascular system occur in up to 10% of all pregnancies and the incidence is increasing. Besides congenital heart disease or pre-existing cardiomyopathy in the mother, the clinical focus has moved especially to peripartum cardiomyopathy (PPCM) because of the condition's dramatic clinical course and the identification of the underlying mechanisms. This review article concentrates therefore on PPCM, which occurs either in the last month of pregnancy or in the first 6 months following delivery in w...
Source: Geburtshilfe und Frauenheilkunde - Category: OBGYN Tags: Geburtshilfe Frauenheilkd Source Type: research
Purpose of review To discuss the risk preexisting or new onset cardiomyopathy/heart failure (CMP/heart failure) in pregnant woman, and recent insights regarding their management and therapy. Recent findings Recent data from the European Registry on Pregnancy and Heart disease of the European Society of Cardiology (ROPAC) suggest that, after an adequate prepregnancy evaluation in specialized centres, the vast majority of pregnancies are safe for both mother and foetus. A tailored approach is required according to cardiac phenotype (i.e. type of cardiomyopathy), clinical and functional status, and new potential treatmen...
Source: Current Opinion in Obstetrics and Gynecology - Category: OBGYN Tags: WOMEN'S HEALTH: Edited by Joseph Aquilina Source Type: research
​BY GREGORY TAYLOR, DO, &SHERIF G. EL-ALAYLI, DOA 30-year-old G5P3 presented to the ED with bilateral lower-extremity edema and headache for three days. She presented one week after an uncomplicated full-term vaginal delivery with an unremarkable pregnancy course and no prior requirement for antihypertensive therapy. The headache was described as achy to sharp, with associated photophobia. She also noted occasional vaginal spotting, which was common a few weeks after delivery. She denied any chest pain, shortness of breath, nausea or vomiting, abdominal pain, or any other symptoms. She admitted to occasional mild cra...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
It is needless to say that heart disease in pregnancy is a challenge for the obstetrician and the cardiologist. Hemodynamic changes in pregnancy and labour can adversely affect many of the significant cardiac lesions. Increase in blood volume and heart rate are the important factors during pregnancy. In general stenotic lesions and pulmonary hypertension are poorly tolerated, while regurgitant lesions are better tolerated. Specific risks like aortic dissection and rupture are there for coarctation of aorta. Several risk stratification schemes have been developed for assessing the risk of pregnancy with heart disease over ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology CARPREG II risk scoring CARPREG risk stratification mWHO classification ZAHARA risk score Source Type: blogs
We describe contraception for two groups of women: (1) women with heart failure and (2) women with cardiac transplantation. RECENT FINDINGS: Medical Eligibility Criteria for contraceptive agents address women with peripartum cardiomyopathy and women with valvular heart disease (Curtis et al. MMWR Recomm Rep 65:1-103, 2016). Recommendations for women with other forms of heart failure are extrapolated from these populations. Recommendations for women with cardiac transplantation have shifted since the 1980s: use of long-acting reversible contraception has increased, and there is a better understanding of the interaction...
Source: MMWR Recomm Rep - Category: Epidemiology Authors: Tags: Curr Heart Fail Rep Source Type: research
We describe contraception for two groups of women: (1) women with heart failure and (2) women with cardiac transplantation.Recent FindingsMedical Eligibility Criteria for contraceptive agents address women with peripartum cardiomyopathy and women with valvular heart disease (Curtis et al. MMWR Recomm Rep 65:1 –103,2016). Recommendations for women with other forms of heart failure are extrapolated from these populations. Recommendations for women with cardiac transplantation have shifted since the 1980s: use of long-acting reversible contraception has increased, and there is a better understanding of the interactions ...
Source: Current Heart Failure Reports - Category: Cardiology Source Type: research
CONCLUSIONS: Findings from this study suggest that women are vulnerable in the time after PPCM diagnosis and struggle to find psychological balance in their life. The need for professional psychological support was often unmet and the physical symptoms were foregrounded in the recovery period. After PPCM, follow-up on psychological wellbeing and morbidity should be offered to women routinely. PMID: 29655005 [PubMed - as supplied by publisher]
Source: Midwifery - Category: Midwifery Authors: Tags: Midwifery Source Type: research
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