Peripartum cardiomyopathy-diagnosis, management, and long term implications

•Peripartum cardiomyopathy (PPCM) is an unusual but important cause of systolic heart failure that affects women worldwide.•The clinical presentation, diagnostic assessment and treatment usually mirror that of other forms of cardiomyopathy.•Timing of delivery and management requires a multidisciplinary approach and individualization.•Subsequent pregnancies should be individualized; in the setting of persistent left ventricular dysfunction, subsequent pregnancies are considered elevated risk. In women with normalized ventricular function, there remains potential for recurrence.•Recovery occurs as many as 50%–70% of women on standard medical therapy for heart failure with reduced ejection fraction, more than in other forms of nonischemic cardiomyopathy. Peripartum cardiomyopathy (PPCM) is a potentially life-threatening pregnancy-associated disease that typically arises in the peripartum period. While the disease is relatively uncommon, its incidence is rising. It is a form of idiopathic dilated cardiomyopathy, defined as pregnancy-related left ventricular dysfunction, diagnosed either towards the end of pregnancy or in the months following delivery, in women without any other identifiable cause. The clinical presentation, diagnostic assessment and treatment usually mirror that of other forms of cardiomyopathy. Timing of delivery and management require a multidisciplinary approach and individualization. Subsequent pregnancies generally carry risk, but individualization is required depending on the pre-pregnancy left ventricular function. Recovery occurs in most women on standard medical therapy for heart failure with reduced ejection fraction, more frequently than in other forms of nonischemic cardiomyopathy. The purpose of this review is to summarize the current state of knowledge with regard to diagnosis, treatment and management, with a focus on long term implications.