Peripartum heart failure: Idiopathic cardiomyopathy or compounding cardiovascular events?

F. G. Cunningham, J. A. Pritchard, Gary Hankins, P. L. Anderson, M. J. Lucas, K. F. Armstrong

Research output: Contribution to journalArticle

150 Citations (Scopus)

Abstract

During a 12-year period, when more than 106,000 women were delivered, 28 women with peripartum heart failure of obscure etiology that initially was diagnosed as peripartum cardiomyopathy were studied. None had obvious underlying cardiac disease or iatrogenic fluid overload, and in all an assiduous search for underlying cardiovascular disease was launched. In 21 of these 28 women, heart failure was attibuted to chronic underlying disease (chronic hypertension in 14, forme fruste mitral stenosis in four, and morbid obesity in one) or viral myocarditis. Importantly, these women also had multiple compounding cardiovascular factors - preeclampsia, cesarean section, anemia, and infection - which, when superimposed on those of pregnancy, acted in concert to cause heart failure. In seven women, the cause for cardiomegaly and global hypokinesis was not found, and peripartum cardiomyopathy was diagnosed. Compared with women with explicable causes of peripartum heart failure, these women did poorly: six had persistent cardiomegaly and heart failure, and four of these died within four months to eight years. From these observations, the authors conclude that idiopathic peripartum cardiomyopathy is uncommon, and that in most women with peripartum heart failure of obscure etiology, underlying chronic diesase will be identified. Heart failure in these women ensues when the cardiovascular demands of normal pregnancy are amplified further by common pregnancy complications superimposed upon these underlying conditions that cause compensated ventricular hypertrophy.

Original languageEnglish (US)
Pages (from-to)157-168
Number of pages12
JournalObstetrics and Gynecology
Volume67
Issue number2
StatePublished - 1986
Externally publishedYes

Fingerprint

Peripartum Period
Cardiomyopathies
Heart Failure
Cardiomegaly
Pregnancy
Morbid Obesity
Pregnancy Complications
Mitral Valve Stenosis
Myocarditis
Pre-Eclampsia
Cesarean Section
Hypertrophy
Anemia
Heart Diseases
Chronic Disease
Cardiovascular Diseases
Hypertension
Infection

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Cunningham, F. G., Pritchard, J. A., Hankins, G., Anderson, P. L., Lucas, M. J., & Armstrong, K. F. (1986). Peripartum heart failure: Idiopathic cardiomyopathy or compounding cardiovascular events? Obstetrics and Gynecology, 67(2), 157-168.

Peripartum heart failure : Idiopathic cardiomyopathy or compounding cardiovascular events? / Cunningham, F. G.; Pritchard, J. A.; Hankins, Gary; Anderson, P. L.; Lucas, M. J.; Armstrong, K. F.

In: Obstetrics and Gynecology, Vol. 67, No. 2, 1986, p. 157-168.

Research output: Contribution to journalArticle

Cunningham, FG, Pritchard, JA, Hankins, G, Anderson, PL, Lucas, MJ & Armstrong, KF 1986, 'Peripartum heart failure: Idiopathic cardiomyopathy or compounding cardiovascular events?', Obstetrics and Gynecology, vol. 67, no. 2, pp. 157-168.
Cunningham FG, Pritchard JA, Hankins G, Anderson PL, Lucas MJ, Armstrong KF. Peripartum heart failure: Idiopathic cardiomyopathy or compounding cardiovascular events? Obstetrics and Gynecology. 1986;67(2):157-168.
Cunningham, F. G. ; Pritchard, J. A. ; Hankins, Gary ; Anderson, P. L. ; Lucas, M. J. ; Armstrong, K. F. / Peripartum heart failure : Idiopathic cardiomyopathy or compounding cardiovascular events?. In: Obstetrics and Gynecology. 1986 ; Vol. 67, No. 2. pp. 157-168.
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