Peripartum Cardiomyopathy, Heart Disorders Before or After Delivery

Peripartum cardiomyopathy is a heart disorder that occurs at the end of pregnancy, before delivery, or several months after delivery. This condition is generally rare, but if not treated immediately, peripartum cardiomyopathy can lead to dangerous complications.

Peripartum cardiomyopathy is a type of cardiomyopathy that occurs in women who are pregnant or have just given birth. This disease can appear near the time of delivery or several days, weeks, and even months (at least 4-5 months) after delivery. If it occurs after 6 months postpartum, then the condition is called postpartum cardiomyopathy.

Peripartum cardiomyopathy is characterized by weakening of the heart muscles, thereby weakening the left ventricle (ventricle). The left heart chamber is the part of the heart that functions to pump blood throughout the body.

As a result of this condition, the heart cannot pump and circulate blood properly throughout the body. In severe conditions, heart failure can occur.

Peripartum Cardiomyopathy Signs and Symptoms

Peripartum cardiomyopathy often appears suddenly and is often not noticed by the sufferer. Women with peripartum cardiomyopathy will usually experience symptoms similar to those of heart failure, including:

  • Easily tired and tired
  • Heart pounding
  • Shortness of breath when lying down or doing activities
  • Frequent urination at night
  • Dizzy
  • Chest pain
  • Swelling in the legs and ankles
  • Coughs

In mild cases, peripartum cardiomyopathy may be asymptomatic. On the other hand, in more severe cases, symptoms such as shortness of breath, swelling, and chest pain may get worse and last longer after delivery.

If you are pregnant or have just given birth and feel some of the symptoms above, you should immediately consult a doctor. The reason is, if treated too late, cardiomyopathy conditions during late pregnancy or postpartum can cause serious complications, such as:

  • Irregular heartbeat (arrhythmia)
  • Heart valve disorders
  • Heart failure
  • Death

Peripartum Cardiomyopathy Causes and Risk Factors

The exact cause of peripartum cardiomyopathy is not known. However, this condition is known to be associated with the performance of the heart muscle which gains weight during pregnancy.

During pregnancy, the heart muscle pumps up to 50 percent more blood than when not pregnant. This is because the presence of the fetus must get a supply of oxygen and nutrients from pregnant women.

Apart from these factors, there are several other factors that can also increase the risk of peripartum cardiomyopathy, including:

  • Overweight or obesity
  • Twin pregnancy
  • Certain diseases, such as hypertension, preeclampsia, diabetes, and heart disorders such as myocarditis, cardiomyopathy or heart weakness, and coronary heart disease
  • Malnutrition or malnutrition
  • Habit of smoking or consuming alcoholic beverages during pregnancy
  • Age over 30 years old
  • Side effects of certain drugs, such as tocolytic drugs to reduce uterine contractions and narcotics, eg (cocaine)

Peripartum Cardiomyopathy Diagnosis and Management

Peripartum cardiomyopathy is important to be detected early by a doctor so that it can be treated immediately. To diagnose this condition, the doctor will perform a physical examination, obstetrical examination, as well as supporting examinations such as chest X-ray, CT scan, echocardiography, electrocardiography (ECG), and blood tests.

If you are diagnosed with peripartum cardiomyopathy, your doctor may recommend that you stay in the hospital. To treat peripartum cardiomyopathy, your doctor will prescribe the following medications:

  • Drug class ACE-inhibitor and beta blocker to help stabilize blood pressure and ease the work of the heart
  • Digitalis drug to strengthen the pumping function of the heart
  • Anticoagulants or blood-thinning medications to prevent blood clots from forming that can worsen cardiomyopathy
  • Diuretic drugs to reduce fluid buildup from the body

The doctor will determine the right type of treatment according to your condition and the fetus in the womb or newborn baby.

In addition to giving medication, the doctor will also advise you to follow a low-salt diet, limit fluid intake, avoid cigarette smoke, and not consume alcoholic beverages.

After your condition improves and your heart has improved, your doctor will let you go home from the hospital, continue to give you medication and advise you to return to control after the medication wears off.

To treat peripartum cardiomyopathy that is severe or not successfully treated with medication, doctors can perform several other treatment steps, such as installing a breathing apparatus to surgery, such as a heart transplant.

Peripartum Cardiomyopathy Prevention Efforts

Women who have had peripartum cardiomyopathy are at risk for it again in a subsequent pregnancy. If the disease occurs a second time, the peripartum cardiomyopathy may get worse.

In addition, to prevent peripartum cardiomyopathy, doctors will generally advise patients to lead a healthy lifestyle, such as:

  • Monitor weight gain during pregnancy and keep it ideal
  • Consult a gynecologist during pregnancy
  • Live a healthy diet during pregnancy and limit high salt intake
  • Stop smoking, consuming alcoholic beverages, and using certain drugs
  • Regular light exercise, for example taking yoga classes, pregnancy exercise, and other activities, such as relaxation and meditation to avoid stress
  • Get enough rest and don't do strenuous physical activity

So that peripartum cardiomyopathy can be detected early, it is important for you to regularly check with your doctor, especially if you have risk factors for experiencing this condition, such as a history of heart problems, preeclampsia, or hypertension.