Treatment:

The woman may need to stay in the hospital until acute symptoms subside.

Because the heart dysfunction is usually reversible, and the women are usually young, everything possible will be done to ensure survival.

This may include taking extreme measures such as:

• Use of a balloon heart pump (aortic counterpulsation balloon)
• Immunosuppressive therapy (such as medicines used to treat cancer or prevent rejection of a transplanted organ)
• Heart transplant if severe congestive heart failure persists

For most women, however, treatment focuses simply on relieving the symptoms. Some symptoms resolve on their own without treatment.

Medications include:

• Digitalis to strengthen the heart's pumping ability
• Diuretics (water pills) to remove excess fluid
• Low-dose beta-blockers

A low-salt diet may be recommended. Fluid may be restricted in some cases. Activities, including nursing the baby, may be limited when symptoms develop.

Daily weighing may be recommended. A weight gain of 3 or 4 pounds or more over 1 or 2 days may be a sign of fluid buildup.

Women who smoke and drink alcohol will be advised to stop, since these habits may make the symptoms worse.

Expectations (prognosis):

There are several possible outcomes in peripartum cardiomyopathy. Some women remain stable for long periods, while others get worse slowly.

Others get worse very quickly and may be candidates for a heart transplant. The death rate may be as high as 25 - 50%.

The outlook is good for women whose hearts returns to normal size after the baby is born. If the heart remains enlarged, future pregnancies may result in heart failure. It is not known how to predict who will recover and who will develop severe heart failure.

Women who develop peripartum cardiomyopathy are at high risk of developing the same problem with future pregnancies and should discuss contraception with their physician.

Complications:

• Cardiac arrhythmias (can be deadly)
• Congestive heart failure
• Pulmonary emboli (blood clots in the lungs)

Calling your health care provider:

Call your health care provider if you are currently pregnant or have recently delivered a baby and think you may have signs of cardiomyopathy.

Also seek medical attention if you develop chest pain, palpitations, faintness, or other new or unexplained symptoms.