Friday March 3, 2006
4 criteria of Peripartum Cardiomyopathy (PPCM)
Contributed by: Saadia Faiz M.D., senior Pulmonary and Critical Care fellow, University of Texas at Houston Program.
Peripartum cardiomyopathy is a deadly disease with mortality described upto 56%. Relationship of heart failure with pregnancy was first described in medical literature about 135 years ago by Virchow & Porack . In 1937 it was recognised as distinct entity with dilated cardiomyopathy by Gouley. 35 years ago Demakis and Rahimtoola defined PPCM on the basis of 4 criteria. It was modified by National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) Workshop in April 1997.
1. Heart failure within the last month of pregnancy or 5 months postpartum.
2. Absence of preexisting heart disease.
3. No determinable etiology and
4. Strict echocardiographic criteria of left ventricular dysfunction: Ejection fraction less than 45%, or M-mode fractional shortening less than 30%, or both, and end-diastolic dimension more than 2.7 cm/m2 body surface area.
Related: Click here to read review article on recognition and management of maternal cardiac disease in pregnancy from British Journal of Anaesthesia (Reference: 2004 93(3):428-439)
References: (second popup overwrites first popup)
1. Peripartum cardiomyopathy. Demakis JG, Rahimtoola SH. Circulation. 1971 Nov;44(5):964-8
2. Peripartum Cardiomyopathy - National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) Workshop Recommendations and Review -JAMA. 2000;283:1183-1188. Full text available with free registration.
3. Peripartum Cardiomyopathy - Cardiology in Review. 14(1):35-42, January/February 2006.