Demographics, management, and outcome of peripartum cardiomyopathy in a community hospital

OBJECTIVE: The purpose of this study was to describe the outcome of peripartum cardiomyopathy in patients cared for in a community hospital. STUDY DESIGN: The cases of peripartum cardiomyopathy treated at Central Baptist Hospital in Lexington, Kentucky, from January 1, 1992, to December 31, 1998, were reviewed. RESULTS: Eleven patients with peripartum cardiomyopathy were identified. The patient population was 91% white and 9% African American. Seventy-two percent of patients were nulliparous, and the prevalence of chronic hypertension was 27%. All patients were examined with echocardiography and met diagnostic criteria for the disease when this modality was used. The mean ejection fraction was 32% +/- 10%. Invasive techniques used to assist in diagnosis included left ventricular catheterization (63%), right ventricular catheterization (54%), and cardiac biopsy (54%). One patient required cardiac transplantation. This patient also had an embolic stroke from a confirmed mural thrombus. No study patient died of the disease, and no other major complications were observed. CONCLUSIONS: The patient profile of peripartum cardiomyopathy in this study differed remarkably from profiles in published reports. Nulliparous white women have better outcomes than indicated by previous reports, probably because of the low frequency of coexisting chronic disease and a younger age at diagnosis.