Peripartum heart failure caused by left ventricular diastolic dysfunction.

Peripartum cardiomyopathy (PPCM) is a rare but serious cause of heart failure occurring in the last month of pregnancy or the first 5 months postpartum. The current definition of PPCM only includes patients with left ventricular systolic dysfunction. The authors present a case of peripartum heart failure with normal ejection fraction and raise the possibility that the definition of PPCM be expanded to include left ventricular diastolic dysfunction. Because the mortality and morbidity of patients with PPCM are higher in women who experience a subsequent pregnancy after a prior episode of pregnancy-related heart failure, a revised definition of PPCM has important potential implications.