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Title: PERIPARTUM CARDIOMYOPATHY: RISK FACTORS, HOSPITAL COURSE AND PROGNOSIS; EXPERIENCES AT LADY READING HOSPITAL PESHAWAR
Authors: Ibrahim Shah, Shah zeb, Syed Tahir Shah, Mohammad Faheem, Rafi Ullah, Mohammad Hafizullah
Journal: The Pakistan Heart Journal (PHJ)
Publisher: Pakistan Cardiac Society
Country: Pakistan
Year: 2012
Volume: 45
Issue: 2
Language: English
Keywords: Risk FactorsPeripartum CardiomyopathyPrognosis.Hospital course
Objective: To study the so-called risk factors associated with peripartumcardiomyopathy (PPCM), its hospital course, short and long term mortality andoutcome of subsequent pregnancies. Methodology: A total of 61 patients diagnosed with PPCM were enrolled in the study. Data regarding risk factors, presenting complaints, complications, pregnancy outcomes, therapeutics used and outcome at 3, 6 and 12 months were recorded.Results: The incidence was estimated to be 1 per 933 deliveries. Mean age±SDwas 30.94±6.63 years. Majority of patients 33(54.1%) were obese. The meanparity was 3.66 ±1.41. Other risk factors were chronic hypertension 19(31.1%), pre-eclampsia 12 (19.7%) and multiple pregnancies 5(8.2%).Forty-three patients 43(70.5%) presented in post partum period while 18(29.5%) in antepartum period. All patients presented with dyspnea. Main ECGfindings were sinus tachycardia 39 (63.9%), LV hypertrophy 42 (68.9%) and Twave inversion 28(45.9%). Ejection fraction was universally reduced onechocardiography. There were 50(82%) live births and 11(18%) perinatal deaths. Main complications were pulmonary edema 7(11.5%), cardiogenic shock8(13.1%) and thromboembolism 13(21.3%). At hospital discharge, 9 (14.8%)patients were dead and 52(85.2%) were discharged with stable heart failure. Atth 12 month follow up, a total of 20(32.8%) were dead while 32(52.5%) hadrecovered fully and 9(14.75%) were still suffering from heart failure. Duringfollow up, only 8(19.5%) pregnancies were detected. Five(62.5%) patients haduneventful course while 3(37.5%) developed heart failure again.Conclusion: Peripartum cardiomyopathy is associated with multiple risk factorsand carries high morbidity and mortality.
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