True statement regarding peripartum cardiomyopathy
i.e. (Subsequent pregnancies are risky): (413-CMDT-11) (1482-H17th)PER1PARTUM CARDIOMYOPATHY* Cardiac dilatation and CHF may develop during the last trimester of pregnancy or within 6 months of delivery* More recently it has been noted that the disease may be related to a cathepsin D cleavage product of the hormone prolactin - suggesting blockage of prolactin may be a potential therapeutic strategy if proven in clinical trials using bromocriptine* More frequently in women over 30 years is generally related to the first or second pregnancy and is associated with gestational hypertension and drugs used to stop uterine contraction.* Many cases improv or resolve completely over several months but other progress to refractory heart failure. About 60% of patients make a complete recovery* The mortality rate of this disorder is around 10%* Patients who recover from peripartum cardiomyopathy should be encouraged to avoid further pregnancies, particularly if LV dysfunction persistThe symptoms, signs and treatment are similar to those in patients with idiopathic dilated cardiomyopathy, the latter including implantation of an ICD or cardiac transplantation if the criteria for these therapies are satisfied
It has 40-50% mortality even with treatment
Long term increased incidence of hypertension
Pre-eclampsia causes the peri-partum cardiomyopathy
Subsequent pregnancies are risky
Miscellaneous (Gynae)