A 30-year-old woman develops exertional dyspnea and orthopnea 2 weeks after delivering her first child. Echocardiogram shows LVEF 35% with global hypokinesia and no regional wall motion abnormalities. Which statement regarding this condition is correct?
- A Subsequent pregnancy is safe if LVEF recovers to >50% within 6 months
- B Bromocriptine is contraindicated due to worsening of heart failure
- C It is defined as heart failure occurring between 20 weeks of gestation and 5 postpartum months ✓
- D It occurs most commonly in the first trimester of pregnancy
Correct answer: C. It is defined as heart failure occurring between 20 weeks of gestation and 5 postpartum months
Explanation
Peripartum cardiomyopathy is defined as idiopathic cardiomyopathy presenting toward the end of pregnancy (typically last month) or within 5 months postpartum, with LVEF <45% and no other cause. It is not a first-trimester condition. Subsequent pregnancy carries high risk even if LVEF recovers. Bromocriptide (which suppresses prolactin) has been studied as adjunctive therapy, not contraindicated.
Reference: Braunwald's Heart Disease, 12th ed.
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Written and medically reviewed by the StethoPrep medical team.