Peripartum Cardiomyopathy

EDITORIAL COMMENT": Cardiomyopathy is an important primary cause of indirect maternal deaths and in the last 3 published triennial reports on maternal deaths in Australia accounted for 2 of 11 deaths due to cardiovascular disease in the 1988-90 triennium (total deaths 96), 3 of 14 in 1985-87 (total deaths 86), and 2 of 14 deaths due to cardiovascular disease in the 1982-84 triennium in which the total number of maternal deaths was 94. This paper reports 3 cases of peripartum cardiomyopathy and provides valuable information concerning diagnosis, differential diagnosis and treatment. Case 1 has the anecdotal advantage of presenting the first successful pregnancy after cardiac transplantation in Australia.
Summary: Peripartum cardiomyopathy is an uncommon condition of unknown aetiology. Diagnosis requires exclusion of other causes of congestive cardiac failure and the demonstration of global ventricular dysfunction on echocardiography. Treatment consists of diuretics, vasodilators, digoxin and anticoagulants. Prognosis is related to recovery of ventricular function. The availability of cardiac transplantation has improved the outlook for those with persistent dysfunction.