Clinical Profile and Outcome of Peripartum Cardiomyopathy among Teenager Patients at the University of the Philippines - Philippine General Hospital
Background. Peripartum cardiomyopathy (PPCM) is a rare form but life-threatening disease condition of the myocardium resulting in decreased ventricular contractility that occurs in a previously healthy woman during the peripartum period. Currently, in our country and probably worldwide there is an absence of epidemiologic data and description of the profile and outcome of PPCM patients less than 19 years old.
Objective. To determine the clinical profile and outcome of peripartum cardiomyopathy among teenagers (14-18 years old) at the University of the Philippines-Philippine General Hospital from 2004-2013
Methods. All patients aged 14-18 years old referred to Section of Pediatric Cardiology during a 10-year period from 2004-2013 who were diagnosed to have peripartum cardiomyopathy fulfilled the criteria set by National Heart, Lung and Blood Institute (NHLBI) were included in the study. We retrieved the medical records of the 25 patients diagnosed with peripartum cardiomyopathy from 2004-2013. The 2D echocardiogram was retrieved from the Pediatric Cardiology Section.
Results. There were 25 teenagers with a mean age of 17 years old diagnosed with PPCM in UP-PGH in 2004-2013. Twenty-one patients (84%) had one sexual partner and two (8%) patients had multiple sexual partners. Their common co-morbidity was preeclampsia. The most common symptoms were dyspnea, easy fatigability, and orthopnea. Most patients presented with NYHA functional class III-IV.
The majority had poor LV contractility (mean EF of 29% and a mean FS of 12.7 %). All had left ventricular enlargement with mean LVEDd of 5.3 cm and mean LVESd of 4.2 cm. LV function improved in 72% of patients after six months. Four (16%) patients died because of myocardial failure.
Conclusion. Peripartum cardiomyopathy is a rare form of cardiomyopathy but it can occur among teenagers age 14-18 years of age. Compared with the previous study our patients are younger, and with a low prevalence of multiple pregnancy and promiscuity. Similar to other studies, preeclampsia and premature labor necessitating the use of tocolytics with Terbutaline are common comorbidities.