Cape Heart Institute, Department of Cardiology and Medicine, University of Cape Town, Cape Town, South Africa.
Scientific Institution of Cardiology and Internal Medicine Almaty, Almaty, Kazakhstan.
Eur J Heart Fail. 2024 Oct;26(10):2143-2154. doi: 10.1002/ejhf.3377. Epub 2024 Aug 8.
This statement focuses on the fact that women with peripartum cardiomyopathy (PPCM) have a substantial mortality and morbidity rate. Less than 50% of patients have full recovery of their cardiac function within 6 months of diagnosis. Also, patients with recovered cardiac function often suffer from comorbidities, such as hypertension or arrhythmias, which require long-term treatment. This has major implications which extend beyond the life of the patient, as it may also substantially impact her family. Women with a new diagnosis of PPCM should be involved in the decision-making processes regarding therapies, e.g. the recommendation to abstain from breastfeeding, or the use of cardiac implantable electronic devices. Women living with PPCM face the uncertainty of not knowing for some time whether their cardiac function will recover to allow them a near-to-normal life expectancy. This not only impacts their ability to work, which may have financial implications, but may also affect mental health and quality of life for the extended family. Women living with PPCM must be informed that a future pregnancy always carries a substantial risk and, in case of poor cardiac recovery, is associated with a high morbidity and mortality. Patients with PPCM are best managed by an interdisciplinary and multiprofessional approach including e.g. a cardiologist, a gynaecologist, nurses, a psychologist, and social workers. The scope of this document encompasses contemporary challenges and approaches for the management of women diagnosed with PPCM.
本声明侧重于这样一个事实,即患有围产期心肌病 (PPCM) 的女性具有较高的死亡率和发病率。不到 50%的患者在诊断后 6 个月内完全恢复心脏功能。此外,心脏功能恢复的患者常患有高血压或心律失常等合并症,需要长期治疗。这意味着除了患者的生命之外,还可能对其家庭产生重大影响。新诊断为 PPCM 的女性应参与治疗决策过程,例如建议避免母乳喂养或使用心脏植入式电子设备。患有 PPCM 的女性面临着一段时间内不确定其心脏功能是否会恢复到允许她们接近正常预期寿命的不确定性。这不仅影响了她们的工作能力(可能会带来经济影响),还可能影响到整个大家庭的心理健康和生活质量。患有 PPCM 的女性必须被告知,未来的怀孕总是存在很大的风险,而且在心脏恢复不佳的情况下,与高发病率和死亡率相关。患有 PPCM 的患者最好通过多学科和多专业的方法进行管理,例如心脏病专家、妇科医生、护士、心理学家和社会工作者。本文件涵盖了诊断为 PPCM 的女性管理的当代挑战和方法。