During a physical exam, the health care provider will look for signs of fluid in the lungs by touching and tapping with the fingers. A stethoscope will be used to listen for lung crackles, a rapid heart rate, or abnormal heart sounds.
The liver may be enlarged and neck veins may be swollen. Blood pressure may be low or may drop when standing up.
Heart enlargement, congestion of the lungs or the veins in the lungs, decreased cardiac output, decreased movement or functioning of the heart, or heart failure may show up on:
For most women, however, treatment mainly focuses on relieving the symptoms. Some symptoms go away on their own without treatment.
Medicines that are often used include:
Digitalis to strengthen the heart's pumping ability
Diuretics ("water pills") to remove excess fluid
A low-salt diet may be recommended. Fluid may be restricted in some cases. Activities, including nursing the baby, may be limited when symptoms develop.
Daily weighing may be recommended. A weight gain of 3 - 4 pounds or more over 1 or 2 days may be a sign of fluid buildup.
Women who smoke and drink alcohol will be advised to stop, since these habits may make the symptoms worse.
There are several possible outcomes in peripartum cardiomyopathy. Some women remain stable for long periods, while others get worse slowly.
Others get worse very quickly and may be candidates for a heart transplant. The death rate may be as high as 25 - 50%.
The outlook is good for women whose hearts returns to normal size after the baby is born. If the heart remains enlarged, future pregnancies may result in heart failure. It is not known how to predict who will recover and who will develop severe heart failure.
Women who develop peripartum cardiomyopathy are at high risk of developing the same problem with future pregnancies. They should discuss birth control methods with their health care provider.
Call your health care provider if you are currently pregnant or have recently delivered a baby and think you may have signs of cardiomyopathy.
Get medical help right away if you develop chest pain, palpitations, faintness, or other new or unexplained symptoms.
Eat a well-balanced diet and get regular exercise to help keep your heart strong. Avoid cigarettes and alcohol. Your doctor may advise you to avoid getting pregnant again if you have had heart failure during a previous pregnancy.
McKenna W. Diseases of the myocardium and endocardium. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 60.
Warnes CA. Pregnancy and heart disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 82.
Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.