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Peripartum Cardiomyopathy
Journal of the American College of Cardiology ( IF 21.7 ) Pub Date : 2020-01-01 , DOI: 10.1016/j.jacc.2019.11.014
Melinda B Davis 1 , Zolt Arany 2 , Dennis M McNamara 3 , Sorel Goland 4 , Uri Elkayam 5
Affiliation  

Peripartum cardiomyopathy is a form of systolic heart failure affecting young women toward the end of pregnancy or in the months following delivery. Incidence is higher in African-American women and in women with older maternal age, hypertensive disorders of pregnancy, and multiple gestation pregnancies. Symptoms of heart failure mimic those of normal pregnancy, often resulting in a delay in diagnosis and preventable complications. Echocardiography showing decreased myocardial function is essential for the diagnosis. Medical management is similar to heart failure with reduced ejection fraction of other etiologies, but adjustments during pregnancy are necessary to ensure fetal safety. Variable outcomes include complete recovery, persistent heart failure, arrhythmias, thromboembolic events, and death. Subsequent pregnancy confers substantial risk of relapse and even death if there is incomplete myocardial recovery. Additional research about the etiology, optimal therapy including the use of bromocriptine, long-term outcomes, and duration of treatment after recovery are needed.

中文翻译:

围产期心肌病

围产期心肌病是一种收缩性心力衰竭,会影响怀孕末期或分娩后几个月的年轻女性。非裔美国女性和孕产妇年龄较大、妊娠期高血压疾病和多胎妊娠的女性发病率更高。心力衰竭的症状与正常妊娠的症状相似,常常导致诊断延误和可预防的并发症。超声心动图显示心肌功能下降对诊断至关重要。医疗管理类似于其他病因的射血分数降低的心力衰竭,但在怀孕期间进行调整是必要的,以确保胎儿安全。可变结果包括完全康复、持续性心力衰竭、心律失常、血栓栓塞事件和死亡。如果心肌恢复不完全,随后的怀孕会增加复发甚至死亡的风险。需要进一步研究病因、最佳治疗(包括溴隐亭的使用)、长期结果和康复后的治疗持续时间。
更新日期:2020-01-01
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