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Cardiomyopathy

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Background

Cardiomyopathy in women of childbearing age can be due to a number of conditions including:
  • Peripartum cardiomyopathy/pregnancy-associated cardiomyopathy
  • Idiopathic dilated cardiomyopathy - some of these cardiomyopathies may be familial
  • Drug-induced cardiomyopathy (for example, Adriamycin)
  • Myocarditis
  • Coronary artery anomalies

Women may present with deteriorating left ventricular systolic function, clinical heart failure, chest pain, atrial or ventricular arrhythmias, stroke or other embolic events, or sudden cardiac death. (1, 2, 3, 4, 5, 6, 7)

Peripartum cardiomyopathy requires special consideration. (4, 5, 6, 7) This form of cardiomyopathy has been defined as a cardiomyopathy presenting in the last month of pregnancy or within 6 months postpartum in the absence of other causes of cardiomyopathy. However, women may present earlier in pregnancy, which likely represents a variant of the same disease (the term “pregnancy-associated cardiomyopathy” has been suggested). The causes of peripartum cardiomyopathy are not known, but risk factors have been identified and include:

a) African race
b) older maternal age
c) Multiple pregnancy
d) Multiparity
e) Pre-eclampsia
f) History of previous peripartum cardiomyopathy


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