Three Cases of Peripartum Cardiomyopathy

ABSTRACT

Peripartum cardiomyopathy(PPCM) is a rare form of cardiomyopathy of unclear cause that can have life-threatening consequences. Cardiac dilatation and congestive heart failure of unexplained cause may develop during the last month of pregnancy or within the first few months after delivery. It is rare, but it varies among geographic regions. Recent estimates of incidence range from 1 15,000 in the United States, 1 6000 in Japan, and 1 1000 in South Africa. The cause of this disorder is unknown but in some patients endomyocardial biopsy has shown evidence of myocarditis, Necropsy shows cardiac enlargement, often with mural thrombi, endocardial thickening and pericardial effusion, along with histologic evidence of myocardial degeneration, fibrosis and lymphocyte infiltration. However, based on recent data, it seems that endocardial biopsies are currently of minor diagnostic and therapeutic benifit in patients with PPCM. The symptoms, signs, and treatment are similar to those in patients with idiopathic dilated cardiomyopathy, but thromboembolic complications are particularly common. The mortality rate is quite variable but may be as high as 25 to 50 percent. We experienced three case of peripartum cardiomyopathy after delivery. The patients were treated with digitalis, vasodilator and diuretic, which induced improvement of the clinical and echocardiographic finding.