Postpartum Cardiomyopathy

What is postpartum cardiomyopathy?

Postpartum cardiomyopathy (PPCM), also known as peripartum cardiomyopathy, is a rare, life-threatening heart disease that develops between the final weeks of pregnancy and 6 months after delivery. The muscles of the heart weaken, which means that it’s harder for the heart to pump blood to the rest of the body. Approximately 1,000 to 1,300 women develop the condition in the U.S. each year. 80% will die of it.

It is suspected to be underdiagnosed, however, as many of the presenting symptoms are attributed to pneumonia or the effects of pregnancy or delivery.

What are the risk factors for postpartum preeclampsia?

Potential risk factors include:

  • Preeclampsia
  • Hypertension (high blood pressure)
  • Tocolytic medication
  • Smoking
  • Multiple pregnancy
  • Teenage pregnancy
  • Pregnancy in older women
  • Poor nutrition
  • Black race

However, 25-33% of all PPCM patients don’t have any obvious risk factors.

What are the symptoms of Postpartum Cardiomyopathy?
  • Fatigue
  • Shortness of breath
  • Low energy and exhaustion
  • Heart palpitations or skipping beats
  • Frequent urination at night (nocturia)
  • Swollen neck veins
  • Low blood pressure
  • Leg swelling (edema)
  • Lack of urination

What is the treatment for Postpartum Cardiomyopathy?

Early detection and treatment are very important for a full recovery. An echocardiogram (ECG) may help to diagnose cardiomyopathy, but a normal ECG does not exclude PPCM. Chest x-rays and other radiologic tests will show an enlarged heart. Referral to a tertiary hospital is mandatory. Heart transplant may be the only option for long-term survival.

There are several types of medications that may be prescribed to treat postpartum cardiomyopathy, including:

  • Angiotensin converting enzyme (ACE) inhibitors
  • Beta blockers
  • Diuretics
  • Digitalis
  • Anticoagulants

Some of these medications are not recommended for breastfeeding mothers, so talk to your doctor if you would like to explore options that are safer for breastfeeding. However, the health of the heart must be a priority.

Who can help diagnose/treat Postpartum Cardiomyopathy?
  • OB/Gyn
  • Primary Care Physician (PCP)


Reviewed By
  • Reviewed by Kimberly Langdon M.D September 2019