PPCM

Q: The most commonly used definition of Peripartum Cardiomyopathy (PPCM) requires the development of heart failure (HF) towards the end of pregnancy or within _________ month(s) following delivery. (select one)

A) One

B) Two 

C) Three

D) Four

E) Five 

Answer: E

The definition developed by the 2010 European Society of Cardiology (ESC) Working Group on Peripartum Cardiology is widely used. It has been included in the 2018 ESC guidelines on managing cardiovascular diseases during pregnancy and in the position statement from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy (PPCM). It requires all three conditions:

- Development of HF in the last month of pregnancy (or toward the end of pregnancy) or within five months following delivery.

- Absence of another identifiable cause for the HF.

- Left ventricular (LV) systolic dysfunction with LV ejection fraction (LVEF) of less than 45 percent, with or without LV dilation.

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References:

1. Sliwa K, Hilfiker-Kleiner D, Petrie MC, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy. Eur J Heart Fail 2010; 12:767.

2. Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy. Kardiol Pol 2019; 77:245.

3. Bauersachs J, König T, van der Meer P, et al. Pathophysiology, diagnosis and management of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy. Eur J Heart Fail 2019; 21:827.