Symptoms:

• Fatigue
• Feeling of racing heart or skipping beats (palpitations)
• Increased night-time urination (nocturia)
• Shortness of breath with activity and when laying flat
• Swelling of the ankles

Signs and tests:

During a physical examination, the physician will look for signs of fluid in the lungs by touching and tapping with the fingers. Listening to the chest with a stethoscope will reveal lung crackles, a rapid heart rate, or abnormal heart sounds.

The liver may be enlarged and neck veins may be swollen. Blood pressure may be low or may drop when the patient stands up.

Heart enlargement, congestion of the lungs or the veins in the lungs, decreased cardiac output, decreased movement or functioning of the heart, or heart failure may show on:

• Chest x-ray
• Chest CT scan
• Coronary angiography
• Echocardiogram
• Nuclear heart scan

A heart biopsy may be helpful in determining an underlying cause of cardiomyopathy. Many cases of peripartum cardiomyopathy seem to be related to myocarditis, which can be confirmed by a heart biopsy.