[This week's cardiology pearl provided by Dr. Semhar Tewelde]
PPCM is diagnosed by echocardiography and increasingly confirmed and complemented with cardiac MRI after the ddx has been ruled-out i.e. pregnancy associated myocardial infarction, valvular heart disease, unrecognized congenital heart disease, hypertensive emergency, amniotic fluid or pulmonary embolism, or pre-eclampsia
PPCM has no histological classification and the role of routine endomyocardial biopsy (EMB) is controversial and remains unclear
Tx includes management of acute heart failure: non-invasive ventilatory/mechanical ventilation, diuretics, vasodilators (nitroglycerine/nitroprusside), inotropes (dobutamine/milrinone), pressors (dopamine), heparin, mechanical circulatory support (IABP, ECMO, LVAD), and finally cardiac transplant
PPCM has a mortality rate as high as 30%
References
Blauwet LA, Cooper LT. Diagnosis and management of peripartum cardiomyopathy.
