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Cardiomyopathy, Peripartum, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Dilated cardiomyopathy occurring during the last month of pregnancy up to 5 mo following the delivery

  • Diagnostic criteria (all required):

    • Onset of myocardial failure during last month ...

Diagnosis

Signs and Symptoms

  • Dyspnea

  • Dizziness

  • Chest pain

  • Orthopnea

  • Cough

  • Paroxysmal nocturnal dyspnea

  • Anorexia

  • Fatigue

  • Arrhythmias

History

  • Onset and duration of symptoms

  • Unexplained persistent cough

  • Excessive wei...

Treatment

Pre-Hospital

Differentiate pulmonary edema from acute reactive airway disease. 

Initial Stabilization/Therapy

ABCs: 
  • Prompt evaluation of respiratory and hemodynamic status

  • Control airway as need...

Follow-Up

Disposition

Admission Criteria

  • Patients with pulmonary edema, cardiogenic shock, or evidence of ischemia should be admitted to the ICU.

  • All symptomatic patients with new onset of peripartum car...

Pearls and Pitfalls

  • Remember high rates of thromboembolism in pregnancy and peripartum cardiomyopathy.

  • Utilize multidisciplinary approach with cardiology and obstetrics consultations.

Additional Reading

  • Johnson-Coyle  L, Jensen  L, Sobey  A. Peripartum cardiomyopathy: Review and practice guidelines. Am J Crit Care.  2012;21(2):89–98.

  • Murali  S, Baldisseri  MR. Peripartum cardio...

Codes

ICD9

674.54 Peripartum cardiomyopathy, postpartum condition or complication 

ICD10

O90.3 Peripartum cardiomyopathy 

SNOMED

  • 62377009 Postpartum cardiomyopathy (disorder)

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