Understanding Peripartum Cardiomyopathy (PPCM) and Pregnancy
“The fear and uncertainty that come with a heart failure diagnosis can feel overwhelming, especially when you’re already navigating the challenges of becoming a new parent.”
For Julia Pierce, that fear became reality when she experienced heart failure while she was pregnant. When that condition continued into postpartum, she experienced a frightening and complex medical journey. Along the way, Pierce found her voice—not only as an advocate for her own health, but also for other women who might one day face the same experience.
“The hardest part of this journey wasn’t just the physical toll,” Pierce said. “It was the emotional and psychological impact.”
Later, Pierce learned that her heart attack was caused by peripartum cardiomyopathy (PPCM), also called postpartum cardiomyopathy. PPCM is a rare form of heart failure that can develop toward the end of pregnancy or in the months after delivery when no other cause of heart failure can be identified. It can occur up to five months after a baby is born and often affects people with no previous history of heart disease.
“In PPCM, the heart chambers enlarge, and the heart muscle becomes weaker,” said Texas Tech Physicians maternal-fetal medicine specialist Shaun Wesley, M.D. “When that happens, the heart can’t pump as much blood with each beat.”
Because the heart isn’t pumping as effectively, people with PPCM may experience symptoms such as:
- Extreme fatigue
- Shortness of breath
- Low blood pressure or dizziness
- Swelling in the legs, feet or abdomen
Wesley explains that PPCM can sometimes be difficult to recognize because many of these symptoms can look similar to normal pregnancy or postpartum changes.
“If these symptoms appear suddenly, become severe or happen when you’re at rest, it’s important to contact your health care provider right away,” he said.
Some factors may increase the risk of developing PPCM, including:
- Being age 35 or older during pregnancy
- High blood pressure, including preeclampsia or gestational hypertension
- Carrying twins or multiples
- Certain ethnic backgrounds
Researchers are still working to understand exactly what causes PPCM. Possible triggers include prior viral illness, nutritional deficiencies, stress on the heart during pregnancy or changes in the immune system. More recent research suggests that certain hormones active during pregnancy may damage blood vessels in the heart.
“We’re learning that these hormones may be higher in women who develop preeclampsia,” Wesley said. “That may help explain why they have a higher risk of developing PPCM.”
While PPCM cannot always be prevented, healthy lifestyle habits may help reduce risk. Wesley recommends avoiding smoking and alcohol, eating a balanced diet and staying physically active as recommended by your health care provider.
The good news is that most women recover with treatment. Medications such as ACE inhibitors, beta blockers, diuretics or blood thinners can help the heart heal and improve symptoms. Only a small number of patients require more advanced treatments.
“The most important thing to know is that this condition is treatable,” Wesley said. “If something doesn’t feel right, speak with your health care provider. We have the tools to diagnose PPCM and start treatment early, which can help you feel better sooner.”
For Pierce, one message stands above all others.
“Speak up for yourself,” she said. “You know your body. Sometimes you have to advocate for yourself and your baby—and you should be proud of doing that.”
The best way to make an informed decision about your future is to talk to your Texas Tech Physicians care team. Request an appointment to talk to your doctor today.
To ensure accurate and reliable information, this post was thoughtfully reviewed and co-written by Shaun Wesley, M.D.