Peripartum Cardiomyopathy in a Pakistani Cohort

Objective: To describe the demographics, risk factors, and clinical presentation in Pakistani patients with peripartum cardiomyopathy. Study Design: A descriptive observational study. Place and Duration of Study: Rawalpindi Institute of Cardiology, Rawalpindi, from June 2014 to June 2015. Methodology: Seventy patients meeting criteria of peripartum cardiomyopathy were included in the study. A detailed history, physical examination and investigations were done. Epidemiologic data, risk factors, New York Heart Association (NYHA) class and echocardiographic findings were recorded. Statistical analyses were done using SPSS version 19. Results: The mean age was 28.66 +/- 4.57 years. Mean parity and weight was 3.04 +/- 1.7 and 60.97 +/- 12.40 Kg, respectively. Fifty-five (78.6%) cases were diagnosed in the postpartum period. Thirty-three (50.8%) and 31 patients (44.7%) presented in NYHA-III and IV classes, respectively. Pregnancy -induced hypertension was seen in 16 (22.9%) cases, diabetes in 6 (8.6%), and twin pregnancy in 2 (2.9%) cases. The mean hemoglobin and brain natriuretic peptide (BNP) was 11.26 +/- 1.61 gm/dl and 1583.70 +/- 1237.65 pg/ml, respectively. Echocardiography showed mean ejection fraction of 21.74 +/- 7.45%. Left ventricle systolic and diastolic diameters were 53.71 +/- 9.74 mm and 63.37 +/- 8.48 mm, respectively. Conclusion: Peripartum cardiomyopathy was seen in younger women with higher parity and pregnancy induced hypertension, often manifesting in the postpartum period with NHYA class III and IV status.