A new mother may encounter a variety of surprises during pregnancy and childbirth. For most of us, however, things go rather smoothly, aside from fatigue and other lingering physical discomforts, we are rarely faced with serious problems related to pregnancy or childbirth. Heart conditions like peripartum cardiomyopathy, which usually occurs during pregnancy or right after, can impact organ function as well as the lungs and other organs at a serious rate.
However, peripartum cardiomyopathy is an incurable disease and since it is treatable in many ways, most mothers who are diagnosed and given the appropriate care lead normal, healthy lives.
Peripartum Cardiomyopathy: What Is It?
During pregnancy, your heart muscles may be weakened resulting in the heart expanding and make it more difficult for it to pump blood. This can adversely affect your heart’s “ejection fraction”, the amount of blood your heart can pump with each heartbeat.
Normally, your ejection fraction is about 60%. Once your rate drops below that, the tendency is to accumulate extra fluid in your body, especially in your lungs and extremities.
Different mothers may experience significantly different degrees of peripartum cardiomyopathy. Though less severe cases are easier to recover from, mothers may still require some care afterward.
With severe cases of peripartum cardiomyopathy, your heart may be unable to provide sufficient oxygenation to the body, and vital organ damage can occur. If the condition is too severe or not properly dealt with, cardiac arrest may occur or become fatal.
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Causes of peripartum cardiomyopathy
Peripartum cardiomyopathy usually occurs in the third trimester of a pregnant woman, or during the first 4 months of pregnancy following pregnancy. It occurs within a fraction of a percent of pregnancies.
peripartum cardiomyopathy may present with an accelerated recovery in women who are then in the second to third weeks of pregnancy. Rapid recovery may take a couple of weeks to a few months.
Oftentimes peripartum cardiomyopathy lasts for years or a lifetime in some women. Although peripartum cardiomyopathy is often fatal in rare cases, it nevertheless occurs.
The exact cause of peripartum cardiomyopathy is not known. Experts believe it stems from a combination of conditions, including genetics, environmental factors, and inflammatory factors. Although causes are not clear, they believe certain factors may put a person at greater risk, including:
- Having African American or Black heritage
- Having more than one baby
- Getting older than 30
- The birth of twins (Read: How To Know If The Pregnancy Is a Twin)
- Experiencing eclampsia or preeclampsia or hypertension
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Symptoms of Peripartum Cardiomyopathy
Cardiomyopathy associated with peripartum occurs the most often near the end of pregnancy or during the first four months after delivery; less than 1% occurs after four months [2]. Symptoms when faced with peripartum cardiomyopathy include:
- Edema (swelling of the hands and feet) (Read: How to avoid swelling of the face during pregnancy)
- Particularly when lying down, shortness of breath
- Feelings of shortness of breath that may cause you to wake up at night
- Extreme fatigue
- Increased weight
- Coughing
- Rapid heartbeat
- Chest pain
All of those symptoms suggest peripartum cardiomyopathy, especially if they develop suddenly or are extremely intense. Only a few of those symptoms necessarily define it as such, though they all warrant medical attention.
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Diagnosis
It’s important to get a complete workup if you suspect you have peripartum cardiomyopathy, since many of the symptoms may overlap with pregnancy syndromes like fatigue and swelling of the extremities, and with other conditions like preeclampsia.
During pregnancy, a doctor may perform either or all of the following tests if they suspect you of having peripartum cardiomyopathy:
- Blood tests
- Echocardiograms
- X-rays of your chest
- MRI tests are a type of magnetic resonance imaging (MRI).
Your prognosis or symptoms may indicate the need for additional diagnostic tests.
Treatment
Your doctor may inform you that the only way to treat mild cases is to carefully monitor your symptoms. If interventions are required, however, they should only be used when your heart pumps enough blood for your system to function normally, you have become short of breath, or fluids build up in your body.
These symptoms are usually treated by:
- Fluid diuretics: These medications help you reduce the excess liquid in your body.
- Beta-blockers: Your heart rate is slowed down so that it can recover between beats more easily
- ACE (angiotensin-converting enzyme) inhibitors: Increased blood volume and decreased blood pressure are the results of these medications, widening blood vessels.
Other treatments can be used, depending on the severity of your health conditions. In very rare circumstances heart pumps and even heart transplants may be recommended. Most of the medications you are prescribed are compatible with breastfeeding. If they aren’t, a breastfeeding-friendly alternative can be given.
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Is it possible for you to have another child?
If you were recently diagnosed with peripartum cardiomyopathy, you probably realize that this could have consequences for your family planning timeline, and if becoming pregnant again will be safe.
The recovery process from peripartum cardiomyopathy depends on how severe it is and how severe it was.
Generally, if you have recovered from an excruciating heart attack before considering another pregnancy, it is safe for you to carry another child. However, your pregnancy can be monitored closely, and you will be considered to be high risk.
You will usually be told not to try getting pregnant again if your heart is not recovered completely. Feeling heartbroken is okay, but a new pregnancy may pose major risks to you and your baby.
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A Word From Kids Rush
The diagnosis of peripartum cardiomyopathy might seem alarming and downright scary. However, it is treatable. Although many moms recover from the chronic condition, there are still some who suffer lasting impacts.
Ask your doctor as many questions as you require if you have been diagnosed with peripartum cardiomyopathy. You will likely have many concerns, and these are all valid.
A peripartum cardiomyopathy diagnosis is significant, and you deserve to be supported, listened to, and cared for if it adversely affects your mental health or ability to give your baby his or her best life.
Sources
[1]. John Hopkins Medicine.
[2]. Bhattacharyya A, Basra SS, Sen P, Kar B. Peripartum cardiomyopathy: a review. Texas Heart Institute Journal. 2012;39(1):8-16.