Saturday, May 27, 2017

Peripartum Cardiomyopathy

A year ago today this was my Facebook status:  "The saga of The Browns versus 2016 continues... So today I went to the Urgent Care for a bladder infection. Turns out my pulse was abnormally high. So they did a EKG which ended up being abnormal from there they took me to the ER for more testing. I am now in observation at the hospital for what the Dr believes (by process of elimination) is postpartum myocardial myopathy. Easiest explanation is that my heart is weak which in turn is causing tachycardia. They are putting me on three different medications. And we are currently praying that this was diagnosed correctly(it was a little difficult to figure out) and that the medicine will help my heart have a full recovery. I appreciate your prayers!!"

Suddenly, faced with a serious medical condition, life was flipped upside down for the second time in 2016. The BAD news: My hearts EF (ejection fraction) was at 35% and we were told that I had heart failure due to pregnancy. The GOOD news: this is something that with the proper medication you can recover from. The BEST news: just 4 months after being diagnosised my heart EF was at 55 - 60% which means my heart did indeed recover. And I am extremely thankful for that! For some people recovery takes years...

There are no known reasons as to what causes PPCM. At first I thought after losing Abby that maybe I had a broken heart (it's a real thing which has similar symptoms) but the doctor said that wasn't the case. I've voiced over and over that I had no PPCM symptoms after having Abby. However, I did have several symptoms after Levi's birth (swelling and high blood pressure). However, even then none of my symptoms were overly obvious nor as intense as many that I've read about and I will never know which pregnancy caused the PPCM. My PPCM was only caught because I thought  knew I had a UTI and the doctor noticed my abnormal heart rate.

However the point of this post isn't really to talk about me. It is to bring more awareness to Post Partum Cardiomyopathy. Per the American Heart Association this is a uncommon form of heart failure. It happens during the last month of pregnancy and up to 5 months after. About 1,000 to 3,000 women develop this condition in the United States each year. Because it's rare it can be mis-diagnosised and depending on the person if left untreated can (and does) lead to death.

Places you can find more information and support are: Pregnancy Induced Heart Failure

PPCM Network 

American Heart Association 

John Hopkins Peripartum Cardiomyopathy

Facebook Group:  Peripartum Cardiomyopathy (ppcm) Survivor Support 

Below is a Heart Failure Quiz that is a great idea to take during the last trimester of pregnancy. Especially if you are experiencing abnormal symptoms.
Heart Failure Quiz (Source – Dr. James Fett ) Please note: that with all tools, there is always the possibility of a false negative or false positive, so if in doubt, please see your doctor and order the relevant blood tests or echocardiogram.
 1. Orthopnea (difficulty breathing while lying flat):
     a.) None = 0 points;
     b.) Need to elevate head = 1 point;
     c.) Need to elevate upper body 45º or more = 2 points
 2. Dyspnea (shortness of breath on exertion):
     a.) None = 0 points;
     b.) Climbing 8 or more steps = 1 point;
     c.) Walking on level = 2 points
 3. Unexplained cough:
     a.) None = 0 points;
     b.) Night-time = 1 point;
     c.) Day and night = 2 points
 4. Swelling (pitting edema) lower extremities:
     a.) None = 0 points;
     b.) Below knee = 1 point;
     c.) Above and below knee and/or hands/face = 2 points.
 5. Excessive weight gain during last month of pregnancy:
    a.) Under 2 pounds per week = 0 points;
    b.) 2 to 4 pounds per week = 1 point;
    c.) over 4 pounds per week = 2 points.
 6. Palpitations (sensation of irregular heart beats):
    a.) None = 0 points;
    b.) When lying down at night = 1 point;
    c.) Day and night, any position = 2 points
 Scoring and Action:
 0 - 2 = low risk -- continue observation
 3 - 4 = mild risk -- consider doing blood BNP and CRP; echocardiogram if BNP and CRP are elevated
 5 or more = high risk -- do blood BNP, CRP, and echocardiogram
An echocardiogram is an ultrasound of the heart and diagnosis is made usually with an echocardiogram.
The B-Type Natriuretic Peptide (BNP) blood test is used to help diagnose heart failure and to determine the severity of that heart failure

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