A 27-year-old woman develops breathlessness and orthopnea four weeks after a normal vaginal delivery. Echo shows a dilated left ventricle with LVEF 32% and no valvular or coronary abnormality. According to accepted diagnostic criteria, the time window required for this presentation to qualify as peripartum cardiomyopathy extends from:

• A First trimester of pregnancy until 3 months postpartum
• B Second trimester of pregnancy until 6 months postpartum
• C Last month of pregnancy until 5 months postpartum ✓
• D Any time during pregnancy until 1 month postpartum

Explanation

Peripartum cardiomyopathy is defined as new-onset heart failure with LVEF below 45 percent occurring between the last month of pregnancy and up to five months postpartum, in the absence of another identifiable cause of ventricular dysfunction. Heart failure developing earlier in gestation is classified as pregnancy-associated heart failure rather than peripartum cardiomyopathy, and onset beyond five months postpartum excludes the diagnosis by convention.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.