Peripartum Cardiomyopathy

Peripartum cardiomyopathy (PPCM) is a rare, idiopathic cardiomyopathy that presents in the last month of pregnancy or a few months postpartum. With reduced ejection fraction and dilated left ventricle, typically a previously healthy patient will present to the emergency setting with shortness of breath or edema, ultimately being diagnosed with congestive heart failure. Untreated PPCM can have high rates of mortality due to cardiogenic shock or thromboembolic events. However, an emergency physician can diagnose and treat with an interdisciplinary team for respiratory support, decrease preload and afterload, and promote contractility of the heart. Special care must be taken if the patient is in her third trimester to ensure adequate perfusion to the placenta. An emergency cesarean section may be indicated to optimize maternal hemodynamic status.