Peripartum Cardiomyopathy 

 

 

Background 

 

  • Definition: new heart failure that develops in the last month of pregnancy or in the first 5 months postpartum 

  • Echocardiogram findings: global dilation & dysfunction, strict criteria for EF ≦ 45%

 

 

Anesthetic Considerations 

 

  • High risk cardiac patient & a very high risk of maternal/fetal M&M

  • Management at a cardiac centre in a multidisciplinary team setting

  • Management of cardiac medications & possible anti-coagulation 

 

 

Anesthetic Management 

 

  • Detailed review of functional capacity, echocardiogram, cardiology consults, & medications 

  • Epidural, spinal, & GA are acceptable if goals met 

  • Neuraxial may be contraindicated if patient anticoagulated 

  • Set up OR for vasopressors, inotropes 

  • Manage in a tertiary cardiac centre with invasive monitoring (arterial line, ± CVP/PAC) + TEE capability 

  • Post-op ICU