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Underestimating a Rare Heart Condition in Pregnant Women

CardioSmart News

More pregnant women are affected by a rare heart condition called peripartum cardiomyopathy than we may think, according to a paper recently published in the European Heart Journal.

This paper summarized current knowledge regarding peripartum cardiomyopathy (PPCM), a rare disorder in which a pregnant woman’s heart becomes weakened and enlarged. In past decades, we’ve come a long way in understanding what PPCM is and who it affects. Yet, as the authors explain, we still face many challenges related to PPCM, particularly regarding the diagnosis and treatment of this rare condition.

PPCM typically develops during the last month of pregnancy or within the first five months after the baby is born, and can be life-threatening, even when treated. Research shows that PPCM is most common after age 30, and certain factors increase risk for this condition, including race, obesity, smoking, alcoholism and heart disorders. There are many symptoms of PPCM, such as fatigue, shortness of breath and heart palpitations, which help identify women impacted by this condition.

The challenge, however, lies in the diagnosis of PPCM. PPCM shares symptoms with more common conditions such as preeclampsia, which occurs when pregnant women develop high blood pressure. As authors explain, it can also be difficult to distinguish between PPCM and normal discomforts associated with pregnancy—like fatigue. Additionally, most patients with PPCM are not initially seen by cardiologists, who are best equipped to diagnose this rare heart condition. Together, these challenges can delay or prevent diagnosis of PPCM.

To address this issue, authors highlight the need for increased awareness of PPCM and more thorough screening in women showing any signs or symptoms of this condition. It’s likely that PPCM is underdiagnosed, and with such a serious heart condition, early diagnosis can go a long way in improving outcomes.

Based on recent findings, authors also advise that PPCM patients do not get pregnant again, as risks associated with a second pregnancy are high. If women with a history of PPCM do get pregnant, appropriate therapy and a team of specialists are recommended to reduce risks.

Despite gaps in our current understanding of PPCM, authors are hopeful that future studies will benefit patients greatly. The European Society of Cardiology is working to establish a worldwide registry, which would collect data on women affected by PPCM to help gain a better understanding of the diagnosis, treatment, and outcomes for this condition. With large clinical registries and further research, authors hope to create the best possible strategies for management of this rare and potentially life-threatening condition.

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