Dr. Fett - Post PPCM Pregancy Question

[SarahsMom]

Dr Fett,

Hello there! Hope you're doing well these days. My husband and I are planning to try for one more baby. I fully recovered my heart function and size after six months. I've been med free for 6 months now and my heart is still strong with an EF of 55%+. My question to you is: If I get pregnant again and have a reoccurance, will I do permanent damage to my heart? Or is it safe to assume that this disease/pregnancy "stunn's" the heart muscles and if I do have a reoccurance I'll heal as fast as the first time?

I'm sorry if the question has been asked before, I couldn't find anything on it through previous posts.

I appreciate your time and effort you give to all of us girls. You truely understand this disease better than any other doctor I've ever seen (and I've seen a bunch).

Thank you,
Kari

[JAMESFETT]

Hi Kari. There are no guarantees, BUT there is accumulating evidence that some women with a previous diagnosis of PPCM do not have a recurrence with a subsequent pregnancy. We are still not able to identify those who have greater risk of recurrence, but we are working on learning more about that. So at this point, there is always a risk of recurrence, and if there is a recurrence sometimes the damage becomes permanent. During the subsequent pregnancy, it is good to monitor each trimester and first month postpartum with:
1)echocardiogram for left ventricular systolic function (EF and FS)
2)blood B-type Natriuretic Peptide, looking for threshold levels that will indicate impending problems with the left ventricle, systolic failure
3)blood high sensitivity-C-Reactive Protein, looking for levels in excess of 10 mg/L, as an indicator of an inflammatory process.

These indicators can alert your physician to be ready for instituting effective treatment. Right now, however, it appears that anyone who has recovered heart function has an 80 per cent chance at least of having successful outcome of pregnancy. Remember the risk of recurrence continues for the first 5 to 6 months or so following delivery. Best wishes.

James

[mikeyandBellesmommy]

kari

I will give you the analogy my cardio gave me, Your heart is like a rubberband and it can be stretched out over nad over but eventually it will lose it's elasticity. Your heart is the same way..

Once recovered any reoccurance could cause the heart to have a harder time going back to normal.. that is why you read all those articles on reoccurance and the heart beign worse the second time around..

I think with close monitoring they catch it to quick for it to get liek it was the first time and that is why the damage isn't as bad as the published info on PPCM says. If ti was let go which it wouldn't be I would imagine it could get worse that the first but you are SO monitored that wouldn't happen..

Like I said my heart took longer this time but it is up to 50-60% from 40% I go in September for another visit and I will let you know what they say!