Name of the Condition

• Peripartum Cardiomyopathy (PPCM)

Summary

• Peripartum cardiomyopathy is a rare form of heart failure that occurs during the last month of pregnancy or within five months after delivery, affecting the heart's ability to pump blood efficiently. This condition can be life-threatening if not managed properly.

Causes

• The exact cause of peripartum cardiomyopathy is unknown, but it may be related to genetic factors, inflammation, immune system responses, hormonal changes, or oxidative stress during and after pregnancy.

Risk Factors

• Risk factors include advanced maternal age, multiple pregnancies, a history of heart disease, high blood pressure during pregnancy, preeclampsia, diabetes, and malnutrition.

Symptoms

• Symptoms typically include fatigue, shortness of breath, swelling of the ankles and feet, increased heart rate, chest pain, and palpitations.

Diagnosis

• Diagnosis may involve an echocardiogram to evaluate heart function, blood tests to measure markers of heart stress or damage, electrocardiograms (ECG) to check electrical activity, and imaging tests like chest X-rays to assess heart size.

Treatment Options

• Treatment usually includes medications such as beta-blockers, ACE inhibitors, and diuretics to help improve heart function and control symptoms. In severe cases, devices like implantable cardioverter-defibrillators (ICD) or heart assist devices, and even heart transplants, may be necessary.

Prognosis and Follow-Up

• The prognosis varies; some women recover completely with appropriate treatment, while others may experience persistent heart dysfunction. Regular follow-up with a cardiologist is essential to monitor heart function and adjust treatments as needed.

Complications

• Complications can include chronic heart failure, arrhythmias, thromboembolism, and in severe cases, death.

Lifestyle & Prevention

• Lifestyle changes include maintaining a balanced diet, engaging in moderated and supervised exercise, avoiding further pregnancies until full recovery, and managing existing health conditions. Preventive measures are difficult due to unclear causes but maintaining overall heart health is recommended.

When to Seek Professional Help

• Immediate medical attention is required if symptoms such as severe shortness of breath, chest pain, palpitations, or fainting occur postpartum or during the last trimester of pregnancy.

Additional Resources

• American Heart Association (AHA)
• Peripartum Cardiomyopathy Support Group

Tips for Medical Coders

• Ensure to distinguish between peripartum cardiomyopathy and other types of cardiomyopathy by noting the timing with pregnancy or postpartum status.
• Be cautious of documenting the correct time frame postpartum, as this impacts the ICD coding accuracy (O90.3).