Peripartum cardiomyopathy (PPCM) is a form of heart muscle disease that affects women during pregnancy, delivery, or several months afterward. PPCM weakens the heart muscle, so that it does not pump blood efficiently to the rest of the body.

PPCM is a very rare condition. It is thought to occur in approximately one case for every 2,000-4,000 live births. It affects roughly 1,000 to 2,000 women annually in the United States.

PPCM is most often found in women while they are in their early 30s, but can occur during any child-bearing age. It has been reported across races including Caucasians, Japanese, Chinese, Indian, and Korean women. PPCM is found less often in Hispanic women.

Symptoms

PPCM symptoms begin in the last month of pregnancy, or in the first five months following birth. These symptoms are often experienced in normal pregnancy, but in PPCM the symptoms are more severe. Symptoms include:

  • Shortness of breath
  • Swelling
  • Fatigue, unexplained and more than normal
  • Significant cough

Risk Factors

Health providers have identified the following risk factors with a higher rate of PPCM. While these factors are associated with PPCM, they do not determine who will or will not actually develop PPCM.

  • Multiple pregnancies
  • Multiple gestations (like twins, triplets, etc.)
  • Older age
  • Non-Caucasian ethnicity
  • Use of tocolytic therapy (like terbutaline) to stop labor
  • High blood pressure
  • Genetic factors, as suggested by emerging research

Causes

Doctors still aren't sure what causes PPCM. Overall, it seems that many factors have a role. Here is a list of proposed reasons why PPCM happens:

  • Abnormal stress
  • Viral infection
  • Abnormal immune response to the growing fetus
  • Abnormal stress on the heart, including increased cardiac demand and high blood pressure
  • Nutritional deficits
  • Nutritional excesses (salt)
  • Hormonal abnormalities
  • Possible genetic links
  • Other environmental factors

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