Current management of patients with severe acute peripartum cardiomyopathy: practical guidance from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy

Johann Bauersachs, Mattia Arrigo, Denise Hilfiker-Kleiner, Christian Veltmann, Andrew J.S. Coats, Maria G. Crespo-Leiro, Rudolf A de Boer, Peter van der Meer, Christoph Maack, Frederic Mouquet, Mark C Petrie, Massimo F Piepoli, Vera Regitz-Zagrosek, Maria Schaufelberger, Petar M Seferovic, Luigi Tavazzi, Frank Ruschitzka, Alexandre Mebazaa, Karen Sliwa

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    156 Citations (Scopus)

    Abstract

    Acute heart failure (AHF) due to peripartum cardiomyopathy (PPCM) provides a challenge for treating physicians. Moreover,in patients still pregnant, therapeutic interventions need always to consider the health of both the mother and the foetus. Especially challenging are severe forms of PPCM, as the mortality of these women is quite high. The use of inotropic drugs and mechanical circulatory support devices may be necessary in the initial phase of severe forms of acute PPCM. Many patients, after initial stabilization, recover LV function.1–3 Unfortunately, some patients need further mechanical circulatory support or urgent heart transplantation despite maximal therapy. In addition, the time frame and extent of recovery are unpredictable, and patients may suffer from cardiac arrest due to ventricular fibrillation in the first months after diagnosis.4 The clinical course may be further aggravated by atrial and/or ventricular thrombus formation with subsequent cardio-embolic complications.
    Original languageEnglish
    Pages (from-to)1096-1105
    Number of pages10
    JournalEuropean Journal of Heart Failure
    Volume18
    Issue number9
    DOIs
    Publication statusPublished - 1 Sept 2016

    Keywords

    • Acute heart failure
    • Initial management
    • Mechanical circulatory support
    • Medical therapy
    • Peripartum cardiomyopathy
    • Post-partum cardiomyopathy
    • Sudden cardiac death

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