My Diagnosis - The Cardiologist

On December 15th, I went to the cardiologist my PCP suggested.  We talked about my symptoms and he asked questions to determine whether I had a history of heart failure or if there was another cause other than pregnancy.  Since I did not have any other cause for heart failure, he believed that it was PPCM.  The following is an excerpt from the American Heart Association's discussion of how PPCM is diagnosed:

PPCM may be difficult to detect because symptoms of heart failure can mimic those of third trimester pregnancy, such as swelling in the feet and legs, and some shortness of breath. More extreme cases feature severe shortness of breath and prolonged swelling after delivery. 

During a physical exam, doctors will look for signs of fluid in the lungs. A stethoscope will be used to listen for lung crackles, a rapid heart rate, or abnormal heart sounds. An echocardiogram can detect the cardiomyopathy by showing the diminished functioning of the heart.

PPCM is diagnosed when the following three criteria are met:

• Heart failure develops in the last month of pregnancy or within 5 months of delivery.
• Heart pumping function is reduced, with an ejection fraction (EF) less than 45% (typically measured by an echocardiogram). EF is how much blood the left ventricle pumps out with each contraction. A normal EF can be between 55 and 70.
• No other cause for heart failure with reduced EF can be found.

The cardiologist prescribed Lasix, a diuretic, to help with the buildup of fluid caused by heart failure.  Removing fluid would help me breathe by removing the fluid from my lungs and reduce swelling.  He sent me to have an echocardiogram (an ultrasound of the heart) later that afternoon to confirm his diagnosis.  The echo would show what my EF was.  My sister came from New Orleans and went with me to my second appointment that day.  Thanks sissy for the curbside service and for being my advocate (I wish everyone had someone to advocate for them and to ask questions because it is difficult to do these things for yourself when facing a serious condition).  The echocardiogram didn't take long but since it was late in the day, I would have to wait until Friday for the results.


When we returned home, I experienced a flood of emotions but I want to cover my thoughts and feelings in a later post. 

On Friday afternoon, the doctor called and told me that I have PPCM. My EF is 15-20% (normal is between 55% and 70%).  I believe I was given some other details that I wasn't able to focus on because the EF was so much lower than I expected.  I was prescribed additional medication and told that I would be fitted with a life vest.  A life vest is a wearable defibrillator worn by heart patients at risk for sudden cardiac arrest (SCA).  It is worn under your clothes at all times except for bathing and it is attached to a..... well I don't know what it is....a monitor maybe.  See for yourself below.

Lifevest