Peripartum Cardiomyopathy: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Peripartum Cardiomyopathy?
A cardiologist, a doctor who treats heart disease, is the main doctor for peripartum cardiomyopathy. Care also often includes a maternal-fetal specialist, a doctor who cares for high-risk pregnancies. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is peripartum cardiomyopathy?
Peripartum cardiomyopathy is a rare disorder in which a pregnant woman's heart becomes weakened and enlarged. It starts late in pregnancy or within 5 months after the baby is born. In the United States, it affects about 1 in 1,000 to 1 in 4,000 pregnant women.
Cardiomyopathy means damage to the heart muscle. The muscle becomes weak and does not pump well, which affects the lungs, liver, and other body systems.
Symptoms
Symptoms can include:
- Fatigue, which means feeling very tired.
- A feeling that your heart is racing or skipping beats, called palpitations.
- Needing to pass urine more often at night.
- Shortness of breath with activity and when lying flat.
- Swelling of the ankles.
These signs are similar to normal pregnancy symptoms, so some women may not realize they have this condition. This can delay diagnosis and treatment.
Causes and who gets it
Scientists are not sure what causes cardiomyopathy during pregnancy. It is a form of dilated cardiomyopathy, a weakening of the heart muscle, in which no other cause of heart weakening can be found. Your risk may be higher if you:
- Are older than 35 or very young, although it can happen at any age.
- Are Black or American Indian/Alaska Native.
- Have or have had high blood pressure during pregnancy, called preeclampsia.
- Do not get enough nutrients through your diet or prenatal vitamins.
- Have health problems such as infections, obesity, diabetes, or autoimmune diseases, which make the body attack its own tissues.
- Are pregnant with twins or more, or have had many pregnancies.
- Smoke or drink a lot of alcohol.
- Take medicines that can damage your heart.
How doctors diagnose it
A provider does a physical exam to look for signs of fluid in the lungs. A stethoscope is used to listen for lung crackles, a fast heart rate, or abnormal heart sounds. Imaging tests may show a large heart, fluid in the lungs, or heart failure.
These tests include a chest x-ray, a chest CT scan, an echocardiogram (a heart ultrasound), a nuclear heart scan, and a cardiac MRI. An echocardiogram will likely show a reduced ejection fraction, a measure of how well the heart pumps. Certain blood tests may show abnormal results.
Treatment
You may need to stay in the hospital until the worst symptoms ease. For most women, treatment mainly focuses on relieving the symptoms. Digitalis is a medicine that strengthens the heart's pumping ability. Diuretics, also called water pills, remove excess fluid. Low-dose beta-blockers and other blood pressure medicines are also often used.
A low-salt diet may be recommended, and fluid may be restricted in some cases. A weight gain of 3 to 4 pounds or more over 1 or 2 days may be a sign of fluid buildup. Women who smoke and drink alcohol will be advised to stop, since these habits may make the symptoms worse.
When severe symptoms occur, care may include extreme steps. These can include an assistive heart pump. They can also include immunosuppressive therapy, which is medicine that calms the immune system. A heart transplant may be needed if severe congestive heart failure persists. Some women with serious complications may need an implanted defibrillator or a wearable cardioverter vest. These devices help keep women from dying of cardiac arrest while their hearts recover. Cardiac arrest is when the heart suddenly stops.
When to see a doctor
Contact your provider if you are pregnant or have recently delivered a baby and think you may have signs of cardiomyopathy. Talk to your provider if you have any symptoms or if your pregnancy symptoms get worse. Call 911 or go to the emergency room if you have chest pain or discomfort lasting two minutes or more, trouble breathing, or if you faint. Get medical help right away if you develop other new or unexplained symptoms.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can do an evaluation, coordinate your heart and pregnancy specialists, and follow up with you after delivery.
Common questions
Is peripartum cardiomyopathy serious?
Yes, it is serious, but it is not common. Some women have serious, long-term, or life-threatening complications. Possible complications include blood clots. Others are an irregular heartbeat, stroke, and heart failure.
Can the heart get better?
Yes, many women recover completely, but some have serious or long-term problems. It is not known how to predict who will recover and who will develop severe heart failure.
Can it happen again in a later pregnancy?
Yes, you have a risk of having this condition again with another pregnancy. The risk is higher if you still have symptoms or complications. Talk to your provider about whether it is safe to become pregnant again.
Is it safe to breastfeed with this condition?
It depends, and your doctor will tell you whether it is safe for you. If your symptoms are serious, your doctor may ask you not to breastfeed your baby. Breastfeeding can cause more stress on your body.
Sources
- MedlinePlus - Peripartum cardiomyopathy
- National Heart, Lung, and Blood Institute - Peripartum Cardiomyopathy and Pregnancy Issues
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
