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No single ac c e p t e d d e finit i ::>n o f Peri-parturn c a rdiac
failu re (PPCF) exis ts at present . c r i teria often used f or
d iagnosis i nclude the dev e lopment of c ardiac failure of an
indeterminate course in t he last month o f pregnancy or with i n
the firs t six postpart um mont hs , i n a s Ubject with previous ly
normal c e rd I ec function p r i o r to the l a s t month o f p r eg nanc y
( 2 09 , 210 ] . The majority of p ati e n t s present within the first
three postpartum months, a lthough c as e s presenting much later
than five mon ths are report ed [194,195 ,204) . signs and
symptoms at presentation are mostly those of biventricular
cardiac failure with cardiomegaly, a nd h yp e rte ns i o n [194,195] .
Th e d isease was first repor ted i n the 19 30' s amo ng North
Amer ican blacks whe re t he incidence rates were repo rted to be
be tween 1 i n 1300-4000 deliveries [204, 210,213 ) . S ince t h e se
f irst reports, t he condition h a s b een reported in many other
countries world-wide [ 19 4 , 215- 21 8 ]. Most of t h e s tudies,
ho we v e r , indicate the disease to be predominantly affect ing
b lacks [204 ,21 1 ,214] .
The exact cause o f peri - partum c a r dia c f a ilure i s unknown ,
althouql-t r esearchers ha v e all uded t o diseases s uch
myocarditis, autoimmune disorders, h y perte n s i v e disorders,
inf ections e t c . [195 , 214 ,219 -221). I t s occurrence h owe ve r is
associated wi th p r e g na nc y a nd postpartum hy pertensive
disorders , t wi n preg nancy , h i gher age and parity, an d a
positive f amily h i s t o r y [1 94, 195 , 2 09-2 14 ] .
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