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Resumen
La cardiomiopatía periparto (CPP) es una cardiomiopatía con disfunción sistólica que se presenta usualmente al final del embarazo y en las primeras semanas del periodo postparto. Los factores de riesgo incluyen etnia afrodescendiente, hipertensión gestacional, preeclampsia, edad materna mayor a 30 años y gestación múltiple. Se han dilucidado varios mecanismos fisiopatológicos implicados en el desarrollo de la CPP tales como un aumento de la prolactina, una disminución en factores transcripcionales antioxidantes como el STAT3 y un aumento de proteínas producidas en la placenta como el sFlt-1, lo que en conjunto produce disfunción endotelial y apoptosis de los cardiomiocitos. La CPP es un diagnóstico de exclusión, por lo que en una mujer con clínica de insuficiencia cardiaca en el periodo periparto se debe descartar otras causas como la cardiomiopatía dilatada o valvular preexistente, infarto agudo del miocardio y tromboembolismo pulmonar. Actualmente el tratamiento se basa en el manejo básico de la insuficiencia cardiaca, además de soporte hemodinámico en caso de ser necesario.
Citas
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