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Question:
I was diagnosed with CHF/cardiomyopathy a week after the birth of my son. Am I facing a heart transplant?
I was diagnosed with CHF/Cardiomyopathy a week after the birth of my son. I've been taking my medications to control my blood pressure and swelling and it has kept them down, however, I have an arrhythmia that is not being controlled. On my EKG, it's showing that in a 6 second span my heart is beating double, 115-120 a minute at times. I am 36 yrs old, and I was diagnosed 4 months ago. I still have pain in my chest quite frequently and I also have pain in my arms and shoulders on occasion. I'm concerned that I may need a heart transplant. Could you give me an idea of what to expect regarding this?
submitted by Samantha from Texas on 11/13/09
Answer:
by Texas Heart Institute cardiologist, Roberta C. Bogaev, MD
Dear Samantha, You have postpartum cardiomyopathy which most likely developed in the third trimester of your pregnancy or shortly after you delivered. Historically, it was recognized that one third of patients improved, one third stayed the same, and one third became worse, necessitating a transplant. However, we understand postpartum cardiomyopathy better today. It is an immune mediated response that was triggered by your immune system when your blood was exposed to your son's blood and genetic signal.
There are a few small studies suggesting intravenous immunoglobulin (IVIG) may decrease your risk of requiring a heart transplant. I have personally given IVIG for postpartum cardiomyopathy about 10-12 times in the past ten years. I have seen a benefit in every case. When used in concert with standard oral medications for heart failure, I have had every patient improve their heart function to normal or near normal levels. It is a drug that should be administered in the hospital. I would be happy to share our protocol with your physician and provide him or her with articles discussing the use of IVIG for postpartum cardiomyopathy.
I share your concern about the fast heart beats, which may represent a serious heart rhythm disorder, ventricular tachycardia. With your young age, recent diagnosis, and persistent symptoms, I would encourage you to discuss with your cardiologist a referral to an advanced heart failure center. A heart transplant center may be able to implement therapies to help you avoid a heart transplant.
Thank you for contacting Ask A Texas Heart Institute Doctor.
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Updated November 2009
