Peripartum Emergencies and Cardiomyopathy with Dr. Anna Engeln

Peripartum cardiomyopathy represents a critical, life-threatening diagnosis of exclusion characterized by heart failure occurring from the third trimester through five months postpartum. With a mortality rate between 4% and 10%, early identification is vital, particularly as the condition often mimics common pregnancy symptoms like fatigue and dyspnea. Diagnosis requires an ejection fraction below 45% and the absence of other identifiable causes. Management centers on optimizing hemodynamics while strictly avoiding contraindicated medications such as ACE inhibitors, ARBs, and spironolactone during pregnancy. Because 16% to 18% of patients may develop apical thrombus, anticoagulation is essential in the first eight weeks. While 50% to 60% of patients achieve full recovery, those with persistent low ejection fractions face high relapse risks in subsequent pregnancies, necessitating careful monitoring and multidisciplinary care.