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PubMed This is a summary of 19 peer-reviewed journal articles Updated
Cardiology

Understanding Your Heart Diagnosis: Validation and Next Steps

At a Glance

Peripartum cardiomyopathy (PPCM) is a rare, treatable form of pregnancy-related heart failure. While a diagnosis can be emotionally overwhelming, roughly half of women recover significant heart function with early treatment. PPCM is a biological event and is absolutely not your fault.

Receiving a diagnosis of Peripartum Cardiomyopathy (PPCM) can feel like a sudden, overwhelming storm in the middle of a time that was supposed to be filled with joy [1][2]. You may have gone from the excitement of a new baby to the high-stakes environment of a cardiology clinic in a matter of days. It is normal to feel a deep sense of “emotional whiplash” as you navigate this transition from healthy expectant or new mother to a patient with a serious heart condition [1][2].

Understanding Your Diagnosis

Peripartum Cardiomyopathy (PPCM) is a rare, life-threatening form of heart failure that occurs without a previously known cause [3][4]. It typically develops during the last month of pregnancy or within the first five months after your baby is born [3][5].

In PPCM, the heart muscle becomes weakened and enlarged, making it difficult for the heart to pump blood effectively to the rest of your body [6][7]. Doctors measure this using your Ejection Fraction (EF)—the percentage of blood the heart pushes out with each beat [6]. In a healthy heart, the EF is usually between 50% and 70%. In PPCM, this number drops, often falling below 45% [3][8].

Three Stabilizing Facts

When a diagnosis feels heavy, it helps to ground yourself in what is medically true:

  1. Many patients recover: Approximately half of women diagnosed with PPCM see significant improvement in their heart function over time [9][10]. With early medical treatment, many see their heart function return to a normal or near-normal range [11][12].
  2. It is highly treatable: While PPCM is serious, it is not a “mystery” to modern medicine. Standard heart failure medications and, in some cases, newer targeted therapies that block specific hormones, have been shown to help the heart heal and improve long-term outcomes [11][13].
  3. It is not your fault: PPCM is a biological event, not a result of your lifestyle, diet, or activity levels [3][14]. Emerging research suggests it may be triggered by hormonal changes, oxidative stress, or genetic predispositions that you were born with [15][7][16]. Nothing you did or didn’t do caused your heart to weaken [14].

The Emotional Impact

The emotional weight of PPCM can be as intense as the physical symptoms. It is common for mothers to feel a sense of vulnerability, sadness, or even post-traumatic stress [2][17]. Nearly 1 in 3 survivors report symptoms of clinical depression [18].

You may feel:

  • Guilt over being unable to care for your baby in the way you planned.
  • Fear about your future health and the ability to have more children.
  • Exhaustion that goes far beyond the typical “new-parent tired.”

Acknowledge these feelings as a valid part of your medical journey. Your psychological well-being is just as important as your heart’s ejection fraction [17][18]. Finding a care team that supports both your physical recovery and your mental health is a vital step in your healing process [2][19]. Because this is a rare condition, it can feel incredibly isolating. Connecting with PPCM-specific support groups or networks can provide immense comfort and remind you that you are not alone.

Common questions in this guide

What is peripartum cardiomyopathy (PPCM)?
PPCM is a rare form of heart failure that develops during the last month of pregnancy or within five months after giving birth. It weakens the heart muscle and makes it harder for your heart to pump blood effectively to the rest of your body.
What does ejection fraction (EF) mean in PPCM?
Ejection fraction is the percentage of blood your heart pumps out with each beat. While a healthy heart usually has an EF between 50% and 70%, a patient with PPCM often has an EF that falls below 45%. Your cardiologist will monitor this number to track your recovery.
Can my heart recover from peripartum cardiomyopathy?
Yes, roughly half of women diagnosed with PPCM see significant improvement in their heart function over time. With early treatment using standard heart failure medications, many patients see their heart function return to a normal or near-normal range.
Did I do something to cause my peripartum cardiomyopathy?
No, developing PPCM is absolutely not your fault. It is a biological event likely triggered by hormonal changes, oxidative stress, or genetics. It is not caused by your lifestyle, diet, or activity levels during pregnancy.
How do I know if my exhaustion is from PPCM or just being a new parent?
While fatigue is expected for new parents, PPCM exhaustion is often much more severe and may be accompanied by shortness of breath or swelling. You should discuss your fatigue levels with your cardiologist to determine what is normal and what is a heart-related symptom.

Questions for Your Doctor

5 questions

  • •What was my exact Ejection Fraction (EF) at diagnosis, and how often will we re-test it?
  • •Based on my initial measurements and biomarkers like NT-proBNP, what is the outlook for my heart's recovery?
  • •How much of my current exhaustion is a normal part of being a new parent versus a symptom of PPCM?
  • •Can you explain the biological causes of PPCM to help me and my family understand that this wasn't caused by anything I did?
  • •What specific symptoms should I watch for that would mean I need to call you immediately or go to the emergency room?

Questions for You

4 questions

  • •What symptoms (like shortness of breath or swelling) did I notice first, and when did they start?
  • •How has this diagnosis affected my ability to care for my baby and myself?
  • •Who in my life can I lean on for emotional support or help with daily tasks while I focus on recovery?
  • •Am I experiencing feelings of guilt, sadness, or intense worry that I should discuss with a mental health professional?

References

References (19)
  1. 1

    Quality of Life in Survivors of Peripartum Cardiomyopathy.

    Koutrolou-Sotiropoulou P, Lima FV, Stergiopoulos K

    The American journal of cardiology 2016; (118(2)):258-63.

    PMID: 27239023
  2. 2

    Psychological adaptation after peripartum cardiomyopathy: A qualitative study.

    de Wolff M, Ersbøll AS, Hegaard H, et al.

    Midwifery 2018; (62()):52-60 doi:10.1016/j.midw.2018.03.012.

    PMID: 29655005
  3. 3

    Peripartum cardiomyopathy: a review.

    Iorgoveanu C, Zaghloul A, Ashwath M

    Heart failure reviews 2021; (26(6)):1287-1296 doi:10.1007/s10741-020-10061-x.

    PMID: 34138401
  4. 4

    The Search for a Crystal Ball to Predict Early Recovery From Peripartum Cardiomyopathy?

    Elkayam U, Habakuk O

    JACC. Heart failure 2016; (4(5)):389-91.

    PMID: 27126284
  5. 5

    The outcome of peripartum cardiomyopathy patients-single center experience.

    Demir E, Ceylan N, Bayraktaroğlu S, et al.

    Echocardiography (Mount Kisco, N.Y.) 2022; (39(12)):1608-1615 doi:10.1111/echo.15498.

    PMID: 36447302
  6. 6

    Persistence of abnormal global longitudinal strain in women with peripartum cardiomyopathy.

    Bortnick AE, Lama von Buchwald C, Hasani A, et al.

    Echocardiography (Mount Kisco, N.Y.) 2021; (38(6)):885-891 doi:10.1111/echo.15071.

    PMID: 33963787
  7. 7

    Genetic and Phenotypic Landscape of Peripartum Cardiomyopathy.

    Goli R, Li J, Brandimarto J, et al.

    Circulation 2021; (143(19)):1852-1862 doi:10.1161/CIRCULATIONAHA.120.052395.

    PMID: 33874732
  8. 8

    New Insights in Peripartum Cardiomyopathy.

    Cruz MO, Briller J, Hibbard JU

    Obstetrics and gynecology clinics of North America 2018; (45(2)):281-298 doi:10.1016/j.ogc.2018.02.002.

    PMID: 29747731
  9. 9

    Clinical presentation, management, and 6-month outcomes in women with peripartum cardiomyopathy: an ESC EORP registry.

    Sliwa K, Petrie MC, van der Meer P, et al.

    European heart journal 2020; (41(39)):3787-3797 doi:10.1093/eurheartj/ehaa455.

    PMID: 32840318
  10. 10

    Burden, predictors and short-term outcomes of peripartum cardiomyopathy in a black African cohort.

    Nabbaale J, Okello E, Kibirige D, et al.

    PloS one 2020; (15(10)):e0240837 doi:10.1371/journal.pone.0240837.

    PMID: 33085703
  11. 11

    A Systematic Review of the Utility of Bromocriptine in Acute Peripartum Cardiomyopathy.

    Badianyama M, Das PK, Gaddameedi SR, et al.

    Cureus 2021; (13(9)):e18248 doi:10.7759/cureus.18248.

    PMID: 34603902
  12. 12

    Heart failure due to peripartum cardiomyopathy presenting in the first week of puerperium-A case series from Nepal.

    Banmala S, Awal S, Bata L, et al.

    Clinical case reports 2024; (12(6)):e9043 doi:10.1002/ccr3.9043.

    PMID: 38827942
  13. 13

    Peripartum Cardiomyopathy Treatment with Dopamine Agonist and Subsequent Pregnancy with a Satisfactory Outcome.

    Melo MA, Carvalho JS, Feitosa FE, et al.

    Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia 2016; (38(6)):308-13 doi:10.1055/s-0036-1584567.

    PMID: 27399926
  14. 14

    A contemporary review of peripartum cardiomyopathy.

    Patel PA, Roy A, Javid R, Dalton JA

    Clinical medicine (London, England) 2017; (17(4)):316-321 doi:10.7861/clinmedicine.17-4-316.

    PMID: 28765406
  15. 15

    Pathophysiology and risk factors of peripartum cardiomyopathy.

    Hoes MF, Arany Z, Bauersachs J, et al.

    Nature reviews. Cardiology 2022; (19(8)):555-565 doi:10.1038/s41569-021-00664-8.

    PMID: 35017720
  16. 16

    Peripartum cardiomyopathy: from genetics to management.

    Sliwa K, Bauersachs J, Arany Z, et al.

    European heart journal 2021; (42(32)):3094-3102 doi:10.1093/eurheartj/ehab458.

    PMID: 34322694
  17. 17

    Post-Traumatic Stress, Depression, and Quality of Life in Women with Peripartum Cardiomyopathy.

    Donnenwirth JA, Hess R, Ross R

    MCN. The American journal of maternal child nursing 2020; (45(3)):176-182 doi:10.1097/NMC.0000000000000614.

    PMID: 32341249
  18. 18

    Depression and health behaviors in women with Peripartum Cardiomyopathy.

    Rosman L, Salmoirago-Blotcher E, Cahill J, et al.

    Heart & lung : the journal of critical care 2017; (46(5)):363-368 doi:10.1016/j.hrtlng.2017.05.004.

    PMID: 28583376
  19. 19

    Peripartum Cardiomyopathy and Spouses' Experiences of Persistent Uncertainty.

    Hess RF, Donnenwirth JA

    MCN. The American journal of maternal child nursing 2022; (47(4)):207-212 doi:10.1097/NMC.0000000000000831.

    PMID: 35749765

This page provides general information about peripartum cardiomyopathy (PPCM) and emotional coping strategies for educational purposes. It does not replace professional medical or psychiatric advice. Always consult your cardiologist for specific questions about your heart function.

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