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peripartum cardiomyopathy (rare type of heart failure (occurs during last…
peripartum cardiomyopathy
rare type of heart failure
occurs during last month of pregnancy or up to 6 months after delivery (Sliwa, 2014)
dilated cardiomyopathy
L ventricle dilating and thins out wall of cardiac tissue
heart cant pump blood properly to the rest of the body
signs and symptoms, NYHA class IV heart failure
SOB, angina even at rest
rapid heartbeat or palpations
excessive fatigue, often bed bound
swelling of feet and ankles
excessive urination at night
weight gain
inability to carry on any physical activity without discomfort
diagnosed by
xray
ct scan
nuclear heart scan
echocardiogram
heart damage, tissue death that is irreversible
heart transplant or balloon heart pump with medical management
LVAD: left ventricular assist device to help with pumping blood until heart transplant is received
complications
arrhythmia
blood clots
CHF
death
elevation of diastolic pressures
decreased cardiac output, increased stroke volume
increased sympathetic nervous system activity
inc HR & vasoconstriction
increased resistance
heart fills more causing muscle tissue to expand further
1 more item...
Compromised heart unable to compensate due to dilation
reduction of renal blood flow and filtration rate, sodium and fluid retention
no definitive cause but possibly from extra pumping of blood for baby with other risk factors
obesity
high blood pressure
diabetes
history of heart disease incl myocarditis
malnutrition
smoking
alcoholism
age
number of pregnancies
secondary to left ventricular systolic dysfunction
ejection fraction reduced
oxidative stress
increase in oxidative damage, compromised antioxidant defense system
elevated serum level associated with pre eclampsia, mechanical stresses on the body
possible disease of endothelium, leading to loss or damage of vasculature
physiological hypertrophy, high levels pregnancy hormones
abnormal hemodynamic response
increased blood volume and cardiac output paired with decrease in afterload
hypertrophy of left ventricle that doesn't resolve after birth like usual
decrease left ventricular function
viruses
peripartum inflammation
lymphocyte infiltration
edema, necrosis and fibrosis
autoimmune response
Embryonic cells escape into blood stream and end in heart of the mother
increased auto antibodies targeting cardiac tissue
Causes inflammation of cardiac tissue
increased inflammatory cytokines
defense mechanism
apoptosis (programmed cell death)
excessive prolactin production
increased blood volume, decreased BP, decreased angiotensin response
decreased hematocrit levels
decreased protein levels in the heart