While pregnancy is a natural health event in a woman’s life, at least 15%-20% of women experience complications with existing health conditions or face a new health complication because of pregnancy. One of those complications can be peripartum cardiomyopathy (PPCM).

How Pregnancy Can Affect Your Heart

PPCM is a weakening of the heart muscle that occurs without apparent cause from the last month of pregnancy through baby’s 6th month postpartum. Peripartum cardiomyopathy usually emerges shortly after birthing. Peripartum cardiomyopathy is a rare illness with symptoms that ranges from mild to severe. Symptoms include:

  • swelling in the legs, ankles, or feet
  • shortness of breath
  • fatigue
  • feeling like your heart is racing or skipping beats
  • need to urinate more frequently at night
  • feeling breathless while laying down
  • swelling in the veins of your neck
  • low blood pressure
  • blood pressure that drops when you stand up

Pay attention to these symptoms because many of them can easily be mistaken as normal third trimester pregnancy or postpartum recovery symptoms. Your pregnancy provider will likely have you undergo an echocardiogram to confirm the condition.

Managing Peripartum Cardiomyopathy

Most women recover on their own without further medical treatment, particularly if they experience severe shortness of breath and prolonged swelling of legs and feet after birth. When the heart doesn’t pump well, fluid can build up in the body, most noticeably in the lungs and the feet.

  • An echocardiogram can detect reduced functioning of the heart
  • Blood tests are used to assess kidney, liver, and thyroid function
  • An assessment of electrolytes, including sodium and potassium; and a complete blood count to look for anemia or evidence of infection may be done as well

What Causes Peripartum Cardiomyopathy?

The underlying cause of PPCM is unclear but researchers have found that genetics may play a role in addition to risk factors including:

  • Obesity
  • History of cardiac disorders, such as inflammation of the heart muscle
  • Smoking
  • Alcoholism
  • Multiple pregnancies
  • Unhealthy eating habits
  • Living in an unhealthy environment

If you’ve ever had peripartum cardiomyopathy, tell your healthcare provider before you have a subsequent pregnancy. You will likely need another echocardiogram to assess the strength of your heart to support a subsequent pregnancy. If echocardiograms show that your heart remains weakened, future pregnancies are strongly discouraged. In these circumstances, the physical stress of pregnancy could cause further damage to your heart and you could risk heart failure, leading to death.

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Natalie Shelton, MSN, APRN, ACNS-C, FNP-C is a dual board-certified Family Nurse Practitioner and Clinical Nurse Specialist.

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