Pregnancy and subsequent pregnancy outcomes in peripartum cardiomyopathy

Mandal, Debasmita; Mandal, S. C.; Mukherjee, Dipankar; Biswas, Subhash Chandra; Maiti, Tapan Kumar; Chattopadhaya, Nibedita; Majumdar, Biswakes; Panja, M

doi:10.1111/j.1447-0756.2010.01378.x

Cited by 50 publications

(40 citation statements)

References 15 publications

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“…173 Multidisciplinary care for patients with PPCM should include cardiologists, high-risk obstetrics and perinatologists, cardiac anesthesiologists, cardiac intensivists, and pediatricians. 158,193 Genetic predisposition can play a role in development of PPCM; therefore, in patients in whom PPCM is suspected who have a familial pattern and history, genetic testing and genetic counseling could be helpful.…”

Section: Diagnosismentioning

confidence: 99%

“…1,191 Mechanical circulatory support (MCS), either as temporary or bridge to transplantation, and heart transplantation have been used successfully in patients with PPCM for whom medical therapy has failed and who require continuous inotropic therapy. 1,158,[209][210][211] Given the hypercoagulable state known to exist during pregnancy, anticoagulation can be considered in patients with PPCM with severe LV dysfunction (LVEF <30%) to prevent thrombus formation, 158,174,193,212 but warfarin should not be used during pregnancy.…”

Section: Treatmentmentioning

confidence: 99%

“…A chest radiograph should be performed to rule out other causes of dyspnea and to assess for cardiomegaly, pleural effusions, and other evidence of congestion. 191,193 An ECG should be performed in patients presenting with presumed PPCM to assess for atrial and ventricular arrhythmias and other electrocardiographic abnormalities (LV hypertrophy, sinus tachycardia, and nonspecific ST-T-wave abnormalities) that are often present in patients presenting with PPCM. 174,191,193 Natriuretic peptide levels (BNP or N-terminal proBNP) are usually elevated in patients with PPCM.…”

Section: Diagnosismentioning

confidence: 99%

“…191,193 An ECG should be performed in patients presenting with presumed PPCM to assess for atrial and ventricular arrhythmias and other electrocardiographic abnormalities (LV hypertrophy, sinus tachycardia, and nonspecific ST-T-wave abnormalities) that are often present in patients presenting with PPCM. 174,191,193 Natriuretic peptide levels (BNP or N-terminal proBNP) are usually elevated in patients with PPCM. 180 Measurement of cardiac troponin at the time of diagnosis can be considered, because it has moderate predictive ability for ventricular recovery, and levels correlate inversely with LV function recovery at follow-up.…”

Section: Diagnosismentioning

confidence: 99%

See 3 more Smart Citations

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

624

663

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CLINICAL STATEMENTS AND GUIDELINEST he intent of this American Heart Association (AHA) scientific statement is to summarize our current understanding of dilated cardiomyopathies. There is special emphasis on recent developments in diagnostic approaches and therapies for specific cardiomyopathies. Recommendations in this document are based on published studies, published practice guidelines from the American College of Cardiology (ACC)/AHA 1 and other organizations, 2,3 and the multidisciplinary expertise of the writing group. Existing evidence in epidemiology, classification, diagnosis, and management of specific cardiomyopathies is usually derived from nonrandomized observational studies, registries, case reports, or expert opinion based on clinical experience, not large-scale randomized clinical trials or systematic reviews. Therefore, in this document, rather than using the standard ACC/AHA classification schema of recommendations and level of evidence, 4 we have included key management strategies at the end of each section and categorized our recommendations according to the level of consensus. Although the format of our recommendations might resemble the ACC/AHA classification of recommendations used in the ACC/AHA practice guidelines, because of the preponderance of expert opinion or level of evidence C evidence in our document, we elected to use different terminology to provide a distinction from the practice guidelines, in which stronger levels and quality of evidence with randomized clinical trials or meta-analyses are usually present. 4 The levels of evidence follow the AHA and ACC methods of classifying the level of certainty of the treatment effect. 4 DEfINITIoN of DILATED CArDIoMyopAThyThe term dilated cardiomyopathy (DCM) refers to a spectrum of heterogeneous myocardial disorders that are characterized by ventricular dilation and depressed myocardial performance in the absence of hypertension, valvular, congenital, or ischemic heart disease. 5 In clinical practice, the pathogenesis of heart failure (HF) has often been placed into 2 categories: ischemic and nonischemic cardiomyopathy. The term nonischemic cardiomyopathy has been interchangeably used with DCM. Although this approach might be practical, it fails to recognize that nonischemic cardiomyopathy can include cardiomyopathies caused by volume or pressure overload (such as hypertension or valvular heart disease) that are not conventionally accepted under the definition of DCM. 1,5 Again, in general practice and clinical research trials, the term ischemic cardiomyopathy is defined as cardiomyopathy caused by ischemic heart disease. Current use of ischemic cardiomyopathy terminology implies ventricular dilation and depressed myocardial contractility caused by ischemia or infarction. CLASSIfICATIoN of CArDIoMyopAThIESThe first classification on this topic categorized cardiomyopathies as heart muscle diseases with dilated (DCM), hypertrophic, restrictive, arrhythmogenic right ventricular (ARVC), or nonclassifiable cardiomyopathy in 1980. 5 Subse...

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Section: Diagnosismentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

Current Diagnostic and Treatment Strategies for Specific Dilated Cardiomyopathies: A Scientific Statement From the American Heart Association

Bozkurt¹,

Colvin²,

Cook³

et al. 2016

Circulation

624

663

View full text Add to dashboard Cite

show abstract

“…Only a few studies have reported on subsequent pregnancies of women with a history of PPCM. 31,32,33,34 Elkayam et al studied 44 women with PPCM and a subsequent pregnancy and found that LVEF increased after the index pregnancy but decreased again during the subsequent pregnancy, irrespective of earlier values. Developments of HF symptoms were more frequent in the group, where LVEF had not normalized before the subsequent pregnancy (44 vs. 21%).…”

Section: Discussionmentioning

confidence: 99%