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Peripartum cardiomyopathy. Insights from Haiti regarding a disease of unknown etiology.

Peripartum cardiomyopathy (PPCM) is a disease of unknown etiology characterized by the onset of left ventricular failure during the period of 1 month antepartum to 5 months postpartum. The PPCM Project at Hospital Albert Schweitzer (HAS) in Haiti has identified 78 cases of PPCM since February 1, 2000, representing an incidence of 1 case per 350 to 400 live births, which is severalfold the estimated incidence in the United States. The reasons for this high incidence in Haiti are unknown. Ongoing investigations have identified the presence of several anticardiac antibodies in many women at HAS who have PPCM, suggesting that PPCM is a unique form of dilated cardiomyopathy and supporting the hypothesis that PPCM has an autoimmune basis. Identification of a high-incidence area for PPCM presents a unique opportunity to make progress in defining potential risk factors, identifying high-risk mothers, detecting underlying etiologies, and discovering more effective new treatments of this often-fatal disease.