A 31-year-old woman presents at 8 weeks postpartum with orthopnea and pedal edema. She had an uncomplicated pregnancy with no known cardiac disease. Echo shows a dilated left ventricle with LVEF 32%. Which statement correctly defines her condition according to accepted diagnostic criteria?

• A Heart failure developing any time during pregnancy or within 12 months of delivery with LVEF below 50%
• B Heart failure occurring exclusively within the first two weeks after delivery in a woman with pre-existing valvular disease
• C Any reduction in LVEF detected on routine postpartum screening echocardiography regardless of symptoms
• D New heart failure between the last month of pregnancy and five months postpartum, with LVEF below 45%, in the absence of another identifiable cause ✓

Explanation

Peripartum cardiomyopathy is defined as new-onset heart failure between the last month of pregnancy and five months postpartum, with LVEF below 45% and no other identifiable cause of heart failure. The narrow time window and exclusion criterion distinguish it from pre-existing cardiomyopathy unmasked by pregnancy, and from pregnancy-associated myocardial infarction or hypertension-related failure. Option A widens the window too much and drops the exclusion clause; options C and B are not recognised definitions.

Reference: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 12th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.