PERIPARTUM CARDIOMYOPATHY
PERIPARTUM CARDIOMYOPATHY
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DOI：
10.1161/01.cir.44.5.964
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发表时间：
1971-01-01
期刊：
影响因子：
37.8
通讯作者：
RAHIMTOOLA, SH
中科院分区：
文献类型：
--
作者：
DEMAKIS, JG;RAHIMTOOLA, SH
围产期心肌病是一种心肌疾病，临床表现为妊娠最后一个月或产后前5个月出现心力衰竭。1849年，里奇首次描述了在产褥期发病的特发性心肌衰竭。1937年，船体和Hafkesbring以及Gouley等人再次认识到产后心肌病。2由于一些报告的患者在妊娠的最后一个月发生心力衰竭，因此使用术语”围产期心肌病”（PPCM）可能更合适。4而不是产后心肌病。PPCM的诊断标准是：（1）在妊娠最后一个月或产后前5个月内发生心力衰竭，（2）心力衰竭的病因不明，（3）妊娠最后一个月前无明显的心脏病。因此，先天性或后天性心脏病或心肌疾病由于可确定的原因被推定为不存在。病因和病理这种疾病的具体病因和发病机制尚不清楚。过量饮酒并不重要。尽管一些作者提到营养不良，但其他作者报告的5例患者营养良好。4 6 7病毒感染，自身免疫机制，激素变化，
PERIPARTUM CARDIOMYOPATHY, a disorder of heart muscle, presents clinical-ly with the onset of cardiac failure in the last month of pregnancy or in the first 5 postpartum months. The first description of idiopathic myocardial failure with onset in the puerperium has been attributed to Ritchie in 1849.1 Postpartum cardiomyopathy was again recognized in 1937 by Hull and Hafkesbring and by Gouley et al. 2 Since some of the reported patients developed cardiac failure in the last month of pregnancy it is probably more appropriate to use the term" peripartum cardiomyopathy"(PPCM) 4rather than postpartum cardiomyopathy. The criteria for the diagnosis of PPCM are:(1) development of heart failure in the last month of pregnancy or within the first 5 postpartum months,(2) absence of a deter-minable etiology for the cardiac failure, and (3) absence of demonstrable heart disease prior to the last month of pregnancy. Thus, congenital, or acquired heart disease or myocardial disease due to determinable causes are presumed to be absent.Etiology and Pathology The specific etiologic factors and pathogenesis of this disorder are not known. Excessive alcoholic intake has not been important. Although some authors have mentioned poor nutrition, 5 patients reported by others have been well nourished. 4 6 7 Viral infection, autoimmune mechanisms, hormonal changes,