How is postpartum cardiomyopathy diagnosed

17.01.2019 09:10

Do not underestimate heart failure caused by pregnancy

Michael Wichert Press and public relations
German Heart Foundation / German Heart Research Foundation

Early diagnosis of gestational cardiomyopathy can save lives. Heart Foundation provides information about rare heart diseases

Shortness of breath, fatigue, and swollen legs: These symptoms are not uncommon in a woman towards the end of pregnancy or after giving birth. However, they could be signs of a serious medical condition called pregnancy-related heart failure, medically peripartum cardiomyopathy (PPCM), or pregnancy cardiomyopathy. "One possible trigger for this form of heart failure is the breastfeeding hormone prolactin, which damages the heart via a complex molecular chain," says cardiologist Prof. Dr. med. Johann Bauersachs from the Scientific Advisory Board of the German Heart Foundation ( and Director of the Clinic for Cardiology and Angiology at the Hannover Medical School (MHH). Detected and treated in time, the heart often recovers completely. If the disease is recognized too late, however, it can be dramatic. You can find detailed information on the development, diagnosis and therapy of this rare heart disease in the article "When pregnancy damages the heart" in the current issue of the heart foundation magazine "Herz heute", which can be obtained free of charge by phone on 069 955128400 or by email under order @ (keyword: "pregnancy") can be requested.

Symptoms are often misinterpreted
It is estimated that one in 1,000 to 1,500 pregnancies will develop peripartum (also: postpartum) cardiomyopathy. The problem: the signs are similar to symptoms that can occur towards the end of pregnancy and after delivery. "The symptoms are therefore often misinterpreted and initially not associated with a weak heart," says Prof. Dr. Denise Hilfiker-Kleiner, Head of Molecular Cardiology and Dean of Research at the MHH and member of the Science Council. However, it is important to always think of pregnancy cardiomyopathy in pregnant women or women who have recently given birth and who show one or more of the symptoms mentioned. Risk factors include an older mother, smoking, multiple pregnancies and high blood pressure.

Diagnosis by heart ultrasound and blood test
If PPCM is suspected, an ECG alone is not enough. In addition to an ultrasound examination of the heart (echocardiography), a blood test is also necessary for diagnosis to detect the proteins that indicate cardiac insufficiency. These two methods can be used to quickly identify or rule out the disease. Once the diagnosis of PPCM has been made, hospitalization is almost always necessary. If heart failure therapy is initiated early in combination with the prolactin blocker bromocriptine and at least prophylactic anticoagulation, pregnancy-related cardiac insufficiency has a good prognosis and most patients recover. Depending on the severity of the disease, it may be necessary to ventilate the patient artificially or to use cardiac support systems. If the patient has not yet given birth, the birth must be carefully planned and monitored by a team of cardiologists, gynecologists, paediatricians and anesthetists.

Good chances of recovery, but also residual risks
If the diagnosis is made in good time and therapy is initiated at an early stage, the chances of recovery are good. In more than half of patients with PPCM, the heart recover completely within the first year of diagnosis. Thirty to 40 percent of women have to accept slight impairments as a result, but many recover in the further course and only about ten percent of those affected have severe cardiac insufficiency (information: ) consist. Nevertheless, residual risks remain, especially with subsequent pregnancies, there is an increased risk of renewed PPCM.

Pregnant women and postpartum mothers should look out for these symptoms:

- Shortness of breath during exertion, possibly also at rest
- swelling of the lower legs and ankles
- tiredness, fatigue, dizziness
- palpitations or palpitations
- Multiple urination at night
- It is not possible to sleep lying down

Tip: Patients and medical professionals can find more information in the expert article "When pregnancy damages the heart" in the current issue of the heart foundation magazine "Herz heute", which can be obtained free of charge by phone at 069 955128400 or by email at bestellung @ herzstiftung. de (keyword: "pregnancy") can be requested.

Printable collage of the above Articles for download at:

Heart specialists write for patients: The current issue of the heart foundation magazine HERZ HEUTE. Collage: C. Marx / DHS.

German Heart Foundation
Press office: Michael Wichert / Pierre König
Tel. 069 / 955128-114 / -140
Email: [email protected]

Original publication:

Töbias König, Denise Hilfiker-Kleiner, Johann Bauersachs: When pregnancy damages the heart - hope for women with peripartal cardiomyopathy, in: Deutsche Herzstiftung (ed.), HERZ HEUTE - Journal of the German Heart Foundation, edition 1/2019, Frankfurt am Main 2018.

Additional Information:
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PM_DHS_Pregnancy Cardiomypathy_2019-01-17

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Nutrition / health / care, medicine
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