Anesthetic management of patients with peripartum cardiomyopathy
- PMID: 36794897
- DOI: 10.1097/ACO.0000000000001244
Anesthetic management of patients with peripartum cardiomyopathy
Abstract
Purpose of review: Cardiovascular disease is increasingly emerging as a cause of peripartum morbidity and mortality. Peripartum cardiomyopathy (PPCM) is defined as pregnancy-related heart failure with a reduced left ventricular ejection fraction <45%. PPCM develops in the peripartum phase and is not an aggravation of an existing prepregnancy cardiomyopathy. Anesthesiologists typically encounter these patients in the peripartum phase in a variety of settings and should be aware of this pathology and its implications for the perioperative management of parturients.
Recent findings: PPCM has been investigated increasingly over the last few years. Significant progress has been made in the assessment of global epidemiology, pathophysiological mechanisms, genetics and treatment.
Summary: Although PPCM is an overall rare pathology, patients can potentially be encountered by any anesthesiologist in many different settings. Therefore, it is important to be aware of this disease and understand the basic implications for anesthetic management. Severe cases often require early referral to specialized centers for advanced hemodynamic monitoring and pharmacological or mechanical circulatory support.
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
References
-
- Regitz-Zagrosek V, Blomstrom Lundqvist C, Borghi C, et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy. Eur Heart J 2011; 32:3147–3197.
-
- Knight M, Bunch K, Tuffnell D, et al. on behalf of MBRRACE-UK. Saving lives, improving mothers’ care – lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2021.
-
- Davis MB, Arany Z, McNamara DM, et al. Peripartum cardiomyopathy: JACC state-of-the-art review. J Am Coll Cardiol 2020; 75:207–221.
-
- Pearson GD, Veille J-C, Shahbudin R, et al. Peripartum cardiomyopathy National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) Workshop Recommendations and Review. JAMA 2000; 283:1183–1188.
-
- Isezuo SA, Abubakar SA. Epidemiologic profile of peripartum cardiomyopathy in a tertiary care hospital. Ethn Dis 2007; 17:228–233.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials
