Heider A L, Kuller J A, Strauss R A, Wells S R
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, 27599-7570 USA.
Obstet Gynecol Surv. 1999 Aug;54(8):526-31. doi: 10.1097/00006254-199908000-00023.
Peripartum cardiomyopathy (PPCM) is a poorly characterized, rare form of cardiomyopathy. The etiology of PPCM is unknown, but viral, autoimmune, and idiopathic causes may contribute. The presentation is similar to other forms of congestive heart failure; the diagnosis of PPCM should not be considered until other causes of cardiac dysfunction are ruled out. Echocardiography is central to diagnosis. Early diagnosis and initiation of treatment are essential to optimize pregnancy outcome. Intensivists and anesthesiologists should be consulted to assist with management in complicated cases. Management of PPCM is essentially supportive. Prognosis is poor, although cardiac transplant is improving prognosis and should be considered when conventional therapy fails.
Obstetricians & Gynecologists, Family Physicians
After completion of this article, the reader will be able to understand the typical presentation of peripartum cardiomyopathy including adverse outcome predictors, to understand how to make the diagnosis of PPCM and how to manage it, and to understand the natural history of the disease.
围产期心肌病（PPCM）是一种特征不明的罕见心肌病形式。PPCM的病因尚不清楚，但病毒、自身免疫和特发性原因可能起作用。其表现与其他形式的充血性心力衰竭相似；在排除其他心脏功能障碍原因之前，不应考虑PPCM的诊断。超声心动图对诊断至关重要。早期诊断和开始治疗对于优化妊娠结局至关重要。对于复杂病例，应咨询重症监护医生和麻醉医生以协助管理。PPCM的管理本质上是支持性的。预后较差，尽管心脏移植正在改善预后，并且在传统治疗失败时应考虑进行心脏移植。
妇产科医生、家庭医生
读完本文后，读者将能够理解围产期心肌病的典型表现，包括不良结局预测因素，理解如何诊断和管理PPCM，以及理解该疾病的自然史。
