PERIPARTUM CARDIOMYOPATHY

Course overview

Pregnant or postpartum women who present with complaints of illness represent a group of patients at high risk for several serious diseases. One of these conditions is known as peripartum cardiomyopathy (PPCM), which is an uncommon and enigmatic type of cardiac failure that only affects women in the last month of pregnancy or within five months after delivery. PPCM is frequently unrecognized when it first presents, primarily because the symptoms of early heart failure are non-specific and overlap with the symptoms of late normal pregnancy. The combination of non-specific early symptoms and the relative rarity of PPCM make up the key ingredients of a potential risk and safety nightmare, which can result in delayed or missed diagnosis. The failure to diagnose and/or appropriately treat PPCM remains a critical issue from both patient safety and medical error perspectives. It is important for practitioners to be aware of key clinical and risk features of this uncommon but devastating cardiac condition. In this activity, we review the clinical features of PPCM, present and discuss two cases to examine some of the most common reasons why the diagnosis of PPCM is missed, delayed, or inappropriately managed, and provide key risk and documentation guidelines. After completing this activity, practitioners should be able to: employ risk factor analysis for PPCM as a part of history-taking for patients with signs or symptoms of PPCM; identify the early signs and symptoms of PPCM; and integrate awareness of the reasons for the failure to diagnose PPCM into clinical practice in order to improve patient safety, improve documentation and decrease the risk of exposure to medical malpractice.