Peripartum cardiomyopathy: A puzzle closer to solution

Table 1 Summary of current state of knowledge about peripartum cardiomyopathy

What do we know about PPCM?	What remains unknown about PPCM?
Awareness is important for making an earlier diagnosis with less dysfunction	Actual “triggers” that initiate the process
Hypertension in pregnancy increases risk for development of PPCM	Role of virus in pathogenesis
Most serious complications can be decreased or avoided	Why higher incidence and more severe disease in those with African heritage
Full recovery occurs more frequently than with any other cardiomyopathy	How important role cardiac autoantibodies play in pathogenesis
Autoimmunity (or immune system dysfunction) a part of pathogenesis	The extent and details of genetic factors
Inflammatory cardiomyopathy is common	Importance of the role of prolactin and prolactin inhibition treatment
Higher incidence and more severe disease in those of African heritage	Importance of the role of sFLT1 in pathogenesis
There can be a genetic predisposition	Why do some recovered have a relapse of heart failure with subsequent pregnancy
Effective evidence-based treatment guidelines available	Role of micronutrients and trace metals in pathogenesis
Most recovered do not have a relapse of heart failure in subsequent pregnancy
Occurs globally, but with geographic variations for incidence and unique characteristics

PPCM: Peripartum cardiomyopathy.