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Case Reports in Obstetrics and Gynecology
Volume 2013, Article ID 563158, 4 pages
http://dx.doi.org/10.1155/2013/563158
Case Report

A Change of Heart: Case Series of Peripartum Cardiomyopathy

1Maternity Unit, Wishaw General Hospital, 50 Netherton Street, Wishaw, South Lanarkshire ML2 0DP, UK
2Scottish Advanced Heart Failure Service, Golden Jubilee National Hospital, Clydebank, Glasgow G42 9TY, UK

Received 29 October 2013; Accepted 2 December 2013

Academic Editors: M. Hanssens and E. Shalev

Copyright © 2013 Sean Martin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Peripartum cardiomyopathy (PPCM) is an uncommon disease of pregnancy, occurring in about 1 in 2000 live births, and is characterized by the development of heart failure, due to left ventricular systolic dysfunction. It is associated with high rates of maternal and neonatal mortality. Cardiac disease is the leading cause of maternal death in the UK: PPCM accounts for about 17% of these. Clinical findings of decompensated heart failure (HF) are often masked by the normal physiological changes seen in pregnancy making the diagnosis challenging. A high index of suspicion is essential—prompting referral for echocardiogram, which is crucial for diagnosis. Favourable prognosis is dependent on the early initiation of HF medications. Although full recovery occurs in around half of cases, left ventricular systolic dysfunction persists in a significant proportion of patients with PPCM and the risk of recurrence in subsequent pregnancies is high. The pathophysiology of PPCM is under intense research. We present four patients with PPCM and a review of the literature. Owing to the diagnostic challenge of PPCM and decompensated HF in pregnant mothers and its high mortality rate without treatment, prompt investigation and referral are key to improving maternal survival.