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Peripartum cardiomyopathy (PPCM), 2021: dialogue with PPCM mothers

PPCM is defined as the development of heart failure during or immediately after pregnancy. Officially, heart failure in this setting is defined as left ventricular ejection fraction (LVEF) of 45% or less [1-3]. However, that level does not define those who are identified earlier and their LVEF may be greater than 45%. In addition, LVEF impairment only describes systolic dysfunction heart failure; and PPCM also involves diastolic dysfunction heart failure-with or without preserved LVEF. Hence, newer definitions must include both systolic and diastolic dysfunction. Similar signs and symptoms may be seen with either and the treatment is also similar [1-5]. It helps in assessing both risks for development of PPCM and existence of early pregnancyassociated cardiomyopathy (PAC) to do blood testing that includes B-type Natriuretic Peptide (BNP), soluble fms-like tyrosine kinase (sFLT1) and Placental Growth Factor (PGF) [6].