Risk factors associated with peripartum cardiomyopathy

ABSTRACT

To determine risk factors associated with peripartum cardiomyopathy in our set up. Coronary care unit, cardiology department Liaquat University Hospital, Hyderabad- Sindh from February to April 2005. Thirty patients with signs and symptoms of heart failure including chest x-ray showing cardiomegally were included in the study. Detailed clinical review of the patients was undertaken. Diagnosis of cardiomyopathy was confirmed on M-Mode / 2D / Colour Doppler Echocardiography. All [30] patients belonged to poor socioeconomic class. Mean age was 29.1 years [range 21-42 years]. Mean parity was 4 [range 1-8] and included primipara 1[3%], multipara 25 [83.3%] and grand multipara were 4[13.3%] patients. Five [16%] patients had gestational hypertension. Twenty-five[83.3%] patients presented with shortness of breath and orthopnea [NYHA Class-IV], 5[16%] with shifted apex beat and 3rd heart sound. All [100%] patients had sinus tachycardia, raised JVP and oedema feet. All patients also showed cardiomegally on x-ray chest. Echocardiograpically, 21 [70%] were having dilated left ventricle [LVIDD>57mm] ranging from 55-75 and reduced ejection fraction i.e, [<40%] ranging from 18-40%. Nine [30%] cases had normal size left ventricle and generalized left ventricular hypokinesia with reduced EF [<40%]. Eighteen [60%] patients were having moderate MR on Colour Doppler Echocardiography. This preliminary study shows that peripartum cardiomyopathy is associated with multiple risk factors in our set up. The most common risk factor is poor socioeconomic status followed by pregnancy with increasing age [>29 years] and multiparity [para >4]