Peripartum Cardiomyopathy (PPCM): How to Diagnose and Deal with?

Monika Sitio, Cholid Tri Tjahjono, Heny Martini, Novi Kurnianingsih


Peripartum cardiomyopathy (PPCM) is a diagnosis of exclusion, where patients present with heart failure (HF) secondary to left ventricular (LV) systolic dysfunction without any other cause of HF identified in the last month of pregnancy or within first five months after delivery, abortion, or miscarriage. PPCM is a life-threatening condition which frequently under diagnosed and inadequately treated, whereas the morbidity and mortality rate ranges between 7% and 50%. Early diagnosis is important to decrease morbidity and mortality. Therefore, it is necessary to report the case related to this condition.

A 34-year-old woman was referred to RSSA with worsening shortness of breath (SOB). She has given birth about 2.5 months prior to admission. History taking and supporting findings form this case were supported to diagnosis of PPCM. She was treated with diuretic, aldosterone antagonist, ACE-I, beta blocker, anticoagulant, and bromocriptine. The symptoms were improved in the following days. She was discharged with better condition and educated to comply with medication.


peripartum cardiomyopathy, heart failure

Full Text:



Bauersachs, J., König, T., van der Meer, P., Petrie, M. C., Hilfiker‐Kleiner, D., Mbakwem, A., & Mueller, C.2019. Pathophysiology, diagnosis and management of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy. European journal of heart failure, 21(7), 827-843.

Hilfiker-Kleiner D, Sliwa K. 2014. Pathophysiology and epidemiology of peripartum cardiomyopathy. Nat Rev Cardiol. 11:364–370.

Honigberg, M. C., & Givertz, M. M. 2019. Peripartum cardiomyopathy. Bmj, 364, k5287.

Huang, Y., Chen, T., Zhang, M., Yang, X., Ding, G., & Yang, L. 2018. Successful management of fatal peripartum cardiomyopathy in a young pregnant woman: A case report. Medicine, 97(15).

Isogai, T., & Kamiya, C. A. 2019. Worldwide incidence of peripartum cardiomyopathy and overall maternal mortality. International heart journal, 60(3), 503-511.

Karafiatova, L., Lazarova, M., & Taborsky, M. 2017. Peripartum cardiomyopathy–A case report and concise review. Cor et Vasa, 59(3), e272-e276.

Kearney, L., Wright, P., Fhadil, S., & Thomas, M. 2018. Postpartum cardiomyopathy and considerations for breastfeeding. Cardiac failure review, 4(2), 112.

Khurana R, Bin Jardan YA, Wilkie J, Brocks DR. 2014. Breast milk concentrations of amiodarone, desethylamiodarone, and bisoprolol following short-term drug exposure: two case reports. J Clin Pharmacol. 54(7): 828–31. PMID:24482268.

Kim, M. J., & Shin, M. S. 2017. Practical management of peripartum cardiomyopathy. The Korean journal of internal medicine, 32(3), 393.

Patten IS, Rana S, Shahul S, Rowe GC, Jang C, Liu L, Hacker MR, Rhee JS, Mitchell J, Mahmood F, Hess P, Farrell C, Koulisis N, Khankin EV, Burke SD, Tudorache I, Bauersachs J, del Monte F, Hilfiker-Kleiner D, Karumanchi SA, Arany Z. 2012. Cardiac angiogenic imbalance leads to peripartum cardiomyopathy. Nature. 485:333–338.

Ponikowski P, Voors AA, Anker SD, et al. 2016. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Eur Heart J. 37(27):2129–200. PMID:27206819.

Prameswari, H. P., Dewi, T. I., Hasan, M., Martanto, E., & Aprami, T. M. 2018. Hypertension in pregnancy as the most influential risk factor for PPCM. Br J Cardiol, 25, 111-4.

Sliwa K, Petrie MC, Hilfiker-Kleiner D, et al. 2018. Long-term prognosis, subsequent pregnancy, contraception and overall management of peripartum cardiomyopathy: practical guidance paper from the Heart Failure Association of the European Society of Cardiology Study Group on Peripartum Cardiomyopathy. Eur J Heart Fail. 20:951–62. PMID:29578284.

Regitz-Zagrosek, V., Roos-Hesselink, J.W., Bauersachs, J., Blomström-Lundqvist, C., Cifkova, R., De Bonis, M., Iung, B., Johnson, M.R., Kintscher, U., Kranke, P. and Lang, I.M., 2018. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy: the task force for the management of cardiovascular diseases during pregnancy of the European Society of Cardiology (ESC). European heart journal, 39(34), pp.3165-3241.

Davis, M.B., Arany, Z., McNamara, D.M., Goland, S. and Elkayam, U., 2020. Peripartum Cardiomyopathy: JACC State-of-the-Art Review. Journal of the American College of Cardiology, 75(2), pp.207-221.



  • There are currently no refbacks.

Copyright (c) 2021 Sitio Monika

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.