Peripartum Cardiomyopathy: Review of the Literature
Yonsei Medical Journal
;
: 731-747, 2007.
Artigo
em Inglês
| WPRIM
| ID: wpr-96367
ABSTRACT
Peripartum cardiomyopathy (PPCM) is a rare but serious form of cardiac failure affecting women in the last months of pregnancy or early puerperium. Clinical presentation of PPCM is similar to that of systolic heart failure from any cause, and it can sometimes be complicated by a high incidence of thromboembolism. Prior to the availability of echocardiography, diagnosis was based only on clinical findings. Recently, inclusion of echocardiography has made diagnosis of PPCM easier and more accurate. Its etiopathogenesis is still poorly understood, but recent evidence supports inflammation, viral infection and autoimmunity as the leading causative hypotheses. Prompt recognition with institution of intensive treatment by a multidisciplinary team is a prerequisite for improved outcome. Conventional treatment consists of diuretics, beta blockers, vasodilators, and sometimes digoxin and anticoagulants, usually in combination. In resistant cases, newer therapeutic modalities such as immunomodulation, immunoglobulin and immunosuppression may be considered. Cardiac transplantation may be necessary in patients not responding to conventional and newer therapeutic strategies. The role of the anesthesiologist is important in perioperative and intensive care management. Prognosis is highly related to reversal of ventricular dysfunction. Compared to historically higher mortality rates, recent reports describe better outcome, probably because of advances in medical care. Based on current information, future pregnancy is usually not recommended in patients who fail to recover heart function. This article aims to provide a comprehensive updated review of PPCM covering etiopathogeneses, clinical presentation and diagnosis, as well as pharmacological, perioperative and intensive care management and prognosis, while stressing areas that require further research.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Complicações Cardiovasculares na Gravidez
/
Prognóstico
/
Recidiva
/
Ecocardiografia Doppler
/
Incidência
/
Fatores de Risco
/
Mortalidade
/
Disfunção Ventricular Esquerda
/
Insuficiência Cardíaca
/
Anestesia Obstétrica
Tipo de estudo:
Estudo de etiologia
/
Estudo de incidência
/
Estudo prognóstico
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Gravidez
Idioma:
Inglês
Revista:
Yonsei Medical Journal
Ano de publicação:
2007
Tipo de documento:
Artigo
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