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/T1_3 38 0 R View Record in Scopus Google Scholar. /Contents 57 0 R 17, 18 Patients may present with severe heart failure during the third trimester or up to 6 months postpartum. /BaseFont /Helvetica >> /Font << 0000005602 00000 n bc74@libero.it. /Parent 7 0 R /Kids [14 0 R 15 0 R 16 0 R 17 0 R] ��5�Trxlx4��Y��l�zLu�%�������}f-?�Ţ �z���0/�����������c��ל�~=�SSDzv��r��~?#.�L��q�#�ڤ��x��!�^��O�� ~�~���,p7�?1�`z,9�_��/�x�#?���ק��8v��O{�f�s�m^�����iIk��ß����MY�D!j 9;Z��9��}!��X,#z����H�h�� =�M�������9g�TÌ o�ρa-nkq��y.nMc�gt/�ňǨ\j��{����;x1��� ;k���������u�8X0�U���k����i��q�3����Z0%���8޷�����ׂٽ�O��܎��3H��9�L���p��M�N?�ۇ��^�OVo�[,���g�Ë9����ˇqD/qt=�h}�P� ʙc�w挳T j��5.\��c�$�5>��n���N��xo��iH�y��x�@N��sNL�;���q�˯z�t��uӔ � ���5�>}�����&|x��͘3����ZA.��-� �8G�J�>��mI�n��[����|w�c���0$�fQ�zAJ��Pvh��q��D*!��oVC�v�m�=�A.d����aHC��&���_�~����{ފ�;�\�Yَ��ze�xA�s��t�dK��|�_$������?�{gKd}�dvIJ���E��e�n��fV�p���Cf��o�E��,P���e���4䜳�r��j�|�^��}�����3��k���|���g�, ����N��o��˗��� Μ X�Y? 2 0 obj 0000032143 00000 n Peripartum cardiomyopathy is a life-threatening condition of unknown cause that occurs in previously healthy women during the peripartum period. /T1_2 38 0 R << Cardiac failure in a previously healthy woman in the last month of pregnan … /T1_7 40 0 R /Type /Pages >> 0000004552 00000 n /Contents 61 0 R /CropBox [0 0 454 680] /GS2 47 0 R Aronow, et al. Peripartum cardiomyopathy is an idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause for heart failure is identified. /Rotate 0 >> doi: 10.1258/td.2008.080353. The disease is relatively uncommon, but its incidence is rising. Heart failure secondary to left ventricular systolic dysfuntion with a LVEF < 45%; Occurrence towards the end of pregnancy or in the months following delivery (mostly in the month following delivery) No other identifiable cause of heart failure; Pathophysiology . /CS3 52 0 R /Font << /T1_4 41 0 R Peripartum Cardiomyopathy From Pathophysiology to Management PDF Free Download. /CS2 52 0 R /T1_6 42 0 R /GS1 46 0 R /XObject << /T1_2 38 0 R 0000002174 00000 n /T1_0 35 0 R PPCM (Peripartum Cardiomyopathy) Authored by patients like you HELPING PEOPLE LIVE BETTER WITH HEART FAILURE A Mum’s Story. /CS4 53 0 R �B7CG!���qyn>rn�DB�����A��/p�*�}�pz`j,�Eҫ�G�s�Z/���d�kz�(~�R7`gi84�wݡ���'Gi�8t�m�n��q~Ĥ��^u�����S瑑'�|��=�Y"����w���eA��Mc��B��R�rl���� @�Q�Y�D�)០�p���! << /GS0 45 0 R /GS3 48 0 R /CS1 50 0 R 4 0 obj /MediaBox [0 0 454 680] Peripartum cardiomyopathy is a rare type of heart muscle disease which occurs during the last part of, or in the first few months after, pregnancy. The condition weakens the heart muscle and … /CS0 49 0 R /CS0 49 0 R >> >> /CropBox [0 0 454 680] 0000013504 00000 n >> /ProcSet [/PDF /Text /ImageC] >> >> endobj uuid:e29a64c3-e784-48cc-a56c-66c9f0443210 /Rotate 0 250 0 obj<> endobj The aetiology and pathophysiological mechanisms of this disease are poorly characterised and incompletely understood. (1) PPCM is a diagnosis of exclusion. /T1_2 37 0 R endobj /Encoding << Rana, A. Saeed, S.A. Shamim, et al. 0000031423 00000 n /GS2 47 0 R Results:Peripartum cardiomyopathy is a cardiomyopathy of unknown cause that occurs in pregnant females, most commonly in the early postpartum period. /GS0 45 0 R 37: 237 Forster O, Libhaber E, Kachope J, Abassi H, Pappachan A, Essop MR, Sliwa K. Peripartum Cardiomyopathy: Correlation between cholesterol, C-reactive protein and left ventricular dysfunction. /CropBox [0 0 454 680] INCIDENCE Type of dilated cardiomyopathy of unknown origin The European Society of Cardiology currently classifies PPCM as a nonfamilial, nongenetic form of dilated cardiomyopathy One in 4000 live birth in United State Less than 0.1 % of pregnancy with comparable good prognosis than other cardiomyopathy Present with LV systolic … << >> 9 0 obj Peripartum cardiomyopathy (PPCM) is a potentially life‐threatening condition typically presenting as heart failure with reduced ejection fraction (HFrEF) in the last month of pregnancy or in the months following delivery in women without another known cause of heart failure. << %���� /CS1 50 0 R /Font << /T1_2 37 0 R /currency 166 /brokenbar 168 /dieresis /copyright /ordfeminine 172 /logicalnot /.notdef /registered /macron /degree /plusminus /twosuperior /threesuperior /CS1 50 0 R /Font << Sommaire 1 Historique 2 Cause 3 Épidémiologie 4 Présentation clinique 5 Biologie 6 Traitement 7 Évolution 8 Notes et références Historique [modifier | … >> Temporal trends in incidence and outcome of peripartum cardiomyopathy in the … /GS1 46 0 R Other significant contributors (5–10% each) are rheumatic heart disease, congenital heart disease and pulmonary hypertension. Access to the PDF text. Peripartum cardiomyopathy is a potentially life-threatening pregnancy-associated disease that typically arises in the peripartum period and is marked by left ventricular dysfunction and heart failure. /T1_1 37 0 R /CS4 53 0 R /T1_0 36 0 R /T1_6 42 0 R The current diagnostic criteria for peripartum cardiomyopathy include1. 0000031773 00000 n 0 /CS4 51 0 R startxref >> Many women recover normal heart function or stabilize on medicines. stream /ZaDb 11 0 R /Parent 7 0 R /CreationDate (D:20110513122838+02'00') /T1_6 42 0 R >> The clinical diagnosis is complex and often made late, as the symptoms tend to mimic those seen in normal pregnancy. • Peripartum cardiomyopathy is a rare type of heart muscle disease which occurs during the last part of, or in the first few months after, pregnancy. >> /CS5 55 0 R /T1_0 36 0 R Peripartum cardiomyopathy (PPCM) is a relatively rare idiopathic form of heart failure that affects women during the last months of pregnancy or the first months after delivery. Peripartum cardiomyopathy is an idiopathic reduction in left ventricular systolic function (ejection fraction <45%) toward the end of pregnancy or in the months after delivery. >> /PitStop 13 0 R 0000003807 00000 n /MediaBox [0 0 454 680] /Parent 9 0 R /ProcSet [/PDF /Text /ImageC] Pregnancy and Peripartum Cardiomyopathy: Journal page Archives Contents list. endobj /Resources << /XObject << /T1_1 37 0 R WHAT IS PERIPARTUM CARDIOMYOPATHY 6. /PDFDocEncoding 12 0 R /MediaBox [0 0 454 680] /CS4 53 0 R /MediaBox [0 0 454 680] /Font << /CC 26 0 R /ModDate (D:20130612203022+02'00') Peripartum cardiomyopathy is a idiopathy cardiomyopathy associated with heart failure towards the end of pregnancy or in the postpartum period. /GS0 45 0 R >> Various mechanisms like myocarditis, autoimmune response to pregnancy, viral infections, selenium deficiency, oxidative stress and prolonged tocolysis 1 0 obj With the current increase in older mothers, obesity, immigration and survival of babies operated on for congenital heart disease, the need to … /ExtGState << /XObject << 24 0 obj /CS2 52 0 R /Type /Page /T1_1 36 0 R The causes and pathogenesis are poorly understood. /Creator (FrameMaker 7.0: LaserWriter 8 FU2-8.7.1) /Author (Conf�rences urgences 2011) Peripartum cardiomyopathy is a form of systolic heart failure affecting young women toward the end of pregnancy or in the months following delivery. /Resources << Definition Development of heart failure in the last month of pregnancy and 5 months postpartum in the absence of a known cause and without any heart disease prior to the last … >> endobj >> /T1_3 35 0 R xref i h�z��@V��#S'� 6X����8��1� r��F�F[oVX�Y�����$��(P������ly�W#�Y��Ш����ج�OrM��e��ܙVq�7�lo2�j�ң`�%7-��;!g }a�sj����mZ%]��qJ��F��M�a�!�w1B1|���w��S��)�Y����\�(؍�i5I�����$=�-�25�� << 0000009120 00000 n >> /Font << /Resources << Le ventricule gauche du coeur se dilate, il ne parvient plus à pomper le sang correctement pour le propulser dans tout le corps. /Contents 70 0 R 0000012217 00000 n INCIDENCE Type of dilated cardiomyopathy of unknown origin The European Society of Cardiology currently classifies PPCM as a nonfamilial, nongenetic form of dilated cardiomyopathy One in 4000 live birth in United State Less than 0.1 % of pregnancy with comparable good prognosis than other cardiomyopathy Present with LV systolic … /T1_4 41 0 R /CS5 55 0 R >> x�bbRg`b``Ń3� �� J�� /Type /Page It is common in some countries and rare in others. Peripartum cardiomyopathy is a idiopathy cardiomyopathy associated with heart failure towards the end of pregnancy or in the postpartum period. Peripartum cardiomyopathy (PPCM) is a pregnancy-associated myocardial disease, that can occur in women of any race or nationality. >> /Parent 8 0 R /T1_4 39 0 R /Rotate 0 26 0 obj << /GS3 48 0 R /Type /Page /Fields [] /GS2 47 0 R /GS3 48 0 R 0000002621 00000 n 0000002764 00000 n /Name /Helv /T1_0 35 0 R The aetiology and pathophysiological mechanisms of this disease are poorly characterised and incompletely understood. Medline Google Scholar; 23. Prognostic value of echocardiography in peripartum cardiomyopathy. /Type /Page Outcome varies from full recovery to resi … /Resources << /XObject << /CropBox [0 0 454 680] /ColorSpace << >> /MediaBox [0 0 454 680] 18 0 obj /T1_7 42 0 R >> /ColorSpace << The Foundation wishes to express a huge vote of thanks to Emma, Tracy, Aleena, Sarah-Jayne, /Font << >> 13 0 obj /Font << >> /T1_5 39 0 R FrameMaker 7.0: LaserWriter 8 FU2-8.7.1 0000003494 00000 n 2013-06-12T20:30:22+02:00 /T1_0 36 0 R /CS3 52 0 R /GS0 45 0 R Pandit V, Shetty S, Kumar A, Sagir A. endobj /CS3 53 0 R Peripartum cardiomyopathy (PPCM) is a rare form of pregnancy-associated cardiac dysfunction. 0000017459 00000 n /GS0 45 0 R /T1_3 38 0 R /Font << /T1_5 39 0 R >> 2011-05-13T12:28:38+02:00 /Contents 62 0 R >> /T1_0 36 0 R /XObject << /T1_3 35 0 R /trademark /fi /fl /Lslash /OE /Scaron /Ydieresis /Zcaron /dotlessi /lslash /oe /scaron /zcaron 160 /Euro 164 /CS3 52 0 R << /T1_4 41 0 R Peripartum cardiomyopathy (PPCM) is defined as the development of cardiac failure between the last month of pregnancy and 5 months postpartum, the absence of an identifiable cause, the absence of recognizable heart disease prior to the last month of pregnancy, and left ventricular systolic dysfunction demonstrated by classic echocardiographic /Im0 58 0 R >> /CS1 50 0 R << >> /T1_0 35 0 R << The guideline defines peripartum cardiomyopathy as. 0000004105 00000 n Acrobat Distiller 5.0.5 pour Macintos Women often recover cardiac function, but long-lasting morbidity and mortality are not infrequent. Prognostic value of echocardiography in peripartum cardiomyopathy. /T1_1 37 0 R Design:An extensive review of the current literature. /Font << 3 0 obj Get the latest information about heart & vascular disorders, treatments, tests and prevention from the No. /GS2 47 0 R /Contents 66 0 R /ProcSet [/PDF /Text /ImageC] << Various mechanisms like myocarditis, autoimmune response to pregnancy, viral infections, selenium deficiency, oxidative stress and prolonged tocolysis have been proposed as the etiology. /Resources << /Length 3020 << /T1_1 37 0 R 0000011929 00000 n /CS2 52 0 R << /T1_3 35 0 R endobj /T1_5 39 0 R Peripartum Cardiomyopathy: From Pathophysiology to Management covers the pathophysiology and the heterogenous mode of presentation of PPCM to assist in risk stratification and provide a guide for the acute and long-term management of women affected by this serious condition. >> /Type /Font /CS0 49 0 R >> >> /PXCViewerInfo (PDF-XChange Viewer;2.5.196.0;Jun 30 2011;20:40:17;D:20130612203022+02'00') /CS5 59 0 R >> Heart failure in peripartum period was first described in 1849. /Metadata 5 0 R /Kids [23 0 R 24 0 R 25 0 R] Peripartum (postpartum) cardiomyopathy (PPCM) is the most common cardiomyopathy in pregnancy. kDa, kilodalton; sFLT1, soluble fms-like tyrosine kinase-1. /CS6 55 0 R /Pages 3 0 R /Length 3463 /CS2 51 0 R 2. >> endobj Peripartum cardiomyopathy Karen Sliwa, James Fett, Uri Elkayam Peripartum cardiomyopathy (PPCM) is a disorder in which initial left ventricular systolic dysfunction and symptoms of heart failure occur between the late stages of pregnancy and the early postpartum period. /T1_7 43 0 R Elle atteint des femmes jeunes et se traduit par une cardiomyopathie dilatée. 0000028690 00000 n • The heart becomes enlarged and weakened, and less able to pump blood than normal. /ocircumflex /otilde /odieresis /divide /oslash /ugrave /uacute /ucircumflex /udieresis /yacute /thorn /ydieresis] /CS0 49 0 R /Rotate 0 /Im0 58 0 R /T1_8 43 0 R >> >> Peripartum cardiomyopathy (PPCM) is a major concern for anaesthetists and can occur in 1 in 10 000 pregnancies, but it is higher in subsequent pregnancies. 23 0 obj ��ғ&�a2�ή� �^c�tU���c�i$�2HjŊĘ��2Y(��L0��B�j)#���U�cxЕPx��-�vyF�����B��hU{��)� rP3�h��. >> << The causes and pathogenesis are poorly understood. /T1_6 42 0 R endobj The objective of peripartum cardiomyopathy treatment is to keep extra fluid from collecting in the lungs and to help the heart recover as fully as possible. Toutefois, le pic de fréquence de survenue de la MCP-PP se situe dans les quelques jours suivant l’accouchement (1). /MediaBox [0 0 454 680] L a cardiomyopathie du péripartum (CPP) est une cause rare d’insuffisance cardiaque (IC). endobj /GS2 47 0 R Abstract—Peripartum cardiomyopathy is a potentially life-threatening pregnancy-associated disease that typically arises in the peripartum period and is marked by left ventricular dysfunction and heart failure. /Subtype /Type1 /ExtGState << endobj /CS3 53 0 R Peripartum cardiomyopathy (PPCM) phenotypically resembles the cardiac characteristics of dilated cardiomyopathy(DCM), but is considered an independent disease, distinct from other forms of cardiomyopathies. >> /CS2 52 0 R /Type /Catalog We aim to raise awareness of the condition and give the clinician an overview of current knowledge on the mechanisms of endobj 0000003956 00000 n /T1_5 40 0 R /GS1 46 0 R /ColorSpace << K.F. 0000002312 00000 n /GS3 48 0 R << /T1_1 36 0 R /T1_7 40 0 R /Rotate 0 Peripartum cardiomyopathy is now increasingly recognized as a cause of heart failure in the later months of pregnancy and early postpartum period. /GS1 46 0 R /ColorSpace << /T1_6 42 0 R Diagnosis remains a challenge, as PPCM symptoms vary and may mimic those commonly … << /XObject << << /T1_3 35 0 R Peripartum cardiomyopathy Authors: Doctor Barbara Maria Colombo1 and Dr Simone Ferrero2 Creation date: October 2004 Scientific Editor: Professor Paola Melacini 1Department of Internal Medicine, San Martino Hospital, University of Genoa, Italy.2Department of Obstetrics and Gynaecology, San Martino Hospital, University of Genoa, Italy. 881 URGENCES 2011 co-fondateurs CARDIOPATHIE DU PÉRIPARTUM 2. Peripartum Cardiomyopathy (PPCM) is an idiopathic cardiomyopathy that presents with heart failure secondary to left ventricular systolic dysfunction toward the end of pregnancy or in the months after delivery. Peripartum cardiomyopathy (PPCM) is a relatively rare idiopathic form of heart failure that affects women during the last months of pregnancy or the first months after delivery. /T1_4 41 0 R 0000009358 00000 n /T1_5 40 0 R >> /GS0 45 0 R A multidisciplinary approach to management with shock team support is key to identifying and adequately treating patients with refractory heart failure and peripartum cardiomyopathy. << Peripartum cardiomyopathy is a form of systolic heart failure affecting young women toward the end of pregnancy or in the months following delivery. >> /ProcSet [/PDF /Text /ImageB /ImageC /ImageI] /CS1 50 0 R /Font << /GS1 46 0 R Mise en garde médicale modifier - modifier le code - voir Wikidata (aide) La cardiomyopathie du peripartum est un tableau d' insuffisance cardiaque survenant typiquement un mois avant l'accouchement et jusqu'à cinq mois après . /ExtGState << /Rotate 0 /GS0 45 0 R /Rotate 0 0000003329 00000 n H��Wˎ]��.e�!�|���@Hf�,� ��(�=r�h��OU���Z2G�e����.V5o��S�� )�7�����0��&X���mFK%�[n��Z�u���3� We review its possible causes and how to recognize and manage it. /Parent 8 0 R /Parent 9 0 R >> /GS1 46 0 R 0000031935 00000 n 0000020280 00000 n 0000004254 00000 n >> >> /GS3 48 0 R 0000001624 00000 n /GS1 46 0 R 0000004701 00000 n Peripartum cardiomyopathy (PPCM) is a rare but potentially fatal disease defined by heart failure towards the end of pregnancy or in the months following delivery. Peripartum Cardiomyopathy: an Update Feriel Azibani1 & Karen Sliwa1,2 Published online: 26 July 2018 # The Author(s) 2018 Abstract Purpose of Review Peripartum cardiomyopathy (PPCM) is an idiopathic disorder defined as heart failure occurring in women during the last month of pregnancy and up to 5 months postpartum. >> PP précoce (« early peripartum cardiomyopathy ») étant alors utilisé pour les affec-tions se manifestant au cours du 7e et 8e mois de grossesse (3). /CS2 51 0 R /Contents [27 0 R 28 0 R 29 0 R 30 0 R 31 0 R 32 0 R 33 0 R 34 0 R] /CS3 53 0 R /CS4 53 0 R /T1_3 38 0 R 14 0 obj /T1_2 38 0 R what is peripartum cardiomyopathy 6. /Im0 58 0 R /Im0 58 0 R [] PPCM is defined as an idiopathic cardiomyopathy that presents with heart failure secondary to left ventricular (LV) systolic dysfunction toward the end of pregnancy or in the months after delivery, in the absence of any other cause of heart failure. >> /ExtGState << /ExtGState << Six of 7 black women and 75% peripartum cardiomyopathy is a diseaseof poor progno- of the multiparous womenhad a poor prognosis.All black sis.At follow-up 16%of our patients died and 50%of the multiparous womenolder than 30 yearshad poor clinical THE AMERICAN JOURNAL OF CARDIOLOGY SEPTEMBER 1, 1989 541 BRIEF REPORTS courses.This is the first seriesof patients with peripartum … /Im0 58 0 R endobj /T1_2 37 0 R /ExtGState << /Parent 9 0 R /T1_4 39 0 R /Parent 8 0 R /T1_1 36 0 R endobj Download a PDF version. /Type /Page /CS7 56 0 R /GS2 47 0 R 0000031987 00000 n endobj /ColorSpace << >> >> peripartum cardiomyopathy. /T1_2 38 0 R >> Peripartum cardiomyopathy (PPCM) is a disorder in which initial left ventricular systolic dysfunction and symptoms of heart failure occur between the late stages of pregnancy and the early postpartum period. /CS2 52 0 R /MediaBox [0 0 454 680] PERIPARTUM. 0000032091 00000 n Incidence varies from 1:300 to 1:15000 /ProcSet [/PDF /Text /ImageC] endobj /Type /Page Women often recover cardiac function, but long-lasting morbidity and mortality are not infrequent. /ColorSpace << << /CS0 49 0 R 0000001994 00000 n /GS1 46 0 R /T1_4 41 0 R uuid:25ad873e-2252-4542-a3ca-82ebef5d0ece du péripartum Peripartum cardiomyopathy F. Mouquet* * Soins intensifs et cardiologie, poly - clinique du Bois; unité de recherche EA 2693, université Lille-Nord de France, Lille. /T1_7 40 0 R 0000007168 00000 n /ExtGState << /CS1 50 0 R /CS0 49 0 R /GS3 48 0 R Incidence is higher in African-American women and in women with older maternal age, hypertensive disorders of … /T1_1 36 0 R /Type /Page >> Heart failure secondary to left ventricular systolic dysfuntion with a LVEF < 45%; Occurrence towards the end of pregnancy or in the months following delivery (mostly in the month following delivery) No other identifiable cause of heart failure; Pathophysiology. >> trailer Conférences urgences 2011 /T1_5 42 0 R /T1_6 40 0 R /Count 5 /T1_5 39 0 R Strong associations have been shown between PPCM and older maternal age, pregnancy‐associated hypertension, multiple pregnancies, African‐American background, and diabetes. >> /CropBox [0 0 454 680] >> >> /MediaBox [0 0 454 680] /CS2 52 0 R /Contents 67 0 R /GS1 46 0 R /Name /ZaDb /Parent 3 0 R /ProcSet [/PDF /Text /ImageC] << /ColorSpace << PDF | Peripartum cardiomyopathy (PPCM) is a rare form of unexplained cardiac failure of unknown origin, unique to the pregnant woman with highly... | Find, read and cite all … The causes and pathogenesis are poorly understood. /CS1 50 0 R endobj endstream endobj 251 0 obj<. Clinical diagnosis may be challenging as it closely resembles several common medical and obstetric complications. Peripartum cardiomyopathy (PPCM) is a disorder in which initial left ventricular systolic dysfunction and symptoms of heart failure occur between the late stages of pregnancy and the early postpartum period. Peripartum cardiomyopathy (PPCM) phenotypically resembles the cardiac characteristics of dilated cardiomyopathy(DCM), but is considered an independent disease, distinct from other forms of cardiomyopathies. /Type /Page << /CS2 51 0 R Cardiomyopathy literally means heart muscle disease. /CS4 51 0 R 0000007091 00000 n /CS4 51 0 R /XObject << >> /GS2 47 0 R << Molecular markers of an inflammatory process are found in most patients. 2009; 39:168–169. /T1_2 38 0 R /Type /Font >> Incidence and outcome of peripartum cardiomyopathy from a tertiary hospital in South India. Access to the PDF text. 0000000016 00000 n >> /DA (/Helv 0 Tf 0 g ) >> /Rotate 0 /T1_6 40 0 R 0000032195 00000 n >> >> PPCM has been classified as a nongenetic form of dilated cardiomyopathy. Peripartum cardiomyopathy characteristics and outcome in a tertiary care hospital. /T1_5 39 0 R /CS3 53 0 R [���\R��#Nk���gr�+�ǺX��lq@����o1'�]b%4t/;j��'@B�I)�߼�"�Tx��Q�6�P��PBN �~2�fy|O�ᦶ(w�����̛�X��� /T1_3 38 0 R /CS4 51 0 R /Rotate 0 The following are key points to remember from this state-of-the-art review on peripartum cardiomyopathy (PPCM): PPCM is an idiopathic condition with left ventricular (LV) systolic dysfunction (ejection fraction [EF] 45%) towards the end of pregnancy or following delivery, when no other cause of … application/pdf /Kids [18 0 R 19 0 R 20 0 R 21 0 R 22 0 R] /ExtGState << /Type /Pages /T1_4 39 0 R << /CS2 51 0 R /CS0 49 0 R >> << 0000016136 00000 n It is common in some countries and rare in others. /CS0 49 0 R /Contents 60 0 R /T1_0 35 0 R /T1_2 37 0 R /CS1 50 0 R >> /Resources << >> /MediaBox [0 0 454 680] >> Peripartum cardiomyopathy Karen Sliwa, James Fett, Uri Elkayam Peripartum cardiomyopathy (PPCM) is a disorder in which initial left ventricular systolic dysfunction and symptoms of heart failure occur between the late stages of pregnancy and the early postpartum period. 5 0 obj It is characterized by left ventricular dysfunction and symptoms of heart failure that can arise in the last trimester of pregnancy or up to 5 months after delivery. /T1_4 39 0 R /CropBox [0 0 454 680] >> << The clinical diagnosis is complex and often made late, as the

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