Peripartum cardiomyopathy: A puzzle closer to solution

Table 3 Role of viral infection in the etiology of peripartum cardiomyopathy: Pathogenesis or mere presence?

ID	PPCM patient	Virus	Type of test	Comments
1	Author case file, Norway	Parvovirus B19	IgM/IgG +	EMB = neg myocarditis
			EMB + PCR
2	Case report, Italy[65]	Coxsackievirus B	IgM + blood	EMB = lymphocytic myocarditis
			PCR + blood
3	Case report, Germany[66]	Parvovirus B19	EMB + PCR	EMB = borderline myocarditis
4	Case report, Germany[66]	Parvovirus B19	EMB + PCR	EMB = borderline myocarditis
5	Case report, Germany[66]	E-B Virus	EMB + PCR	EMB = borderline myocarditis
6	Case report, Germany[66]	Human Herpesvirus 6	EMB + PCR	EMB = borderline myocarditis
7	Case report, Germany[66]	Human Herpesvirus 6	EMB + PCR	EMB = borderline myocarditis
8	Case report, Germany[66]	Cytomegalovirus	EMB + PCR	EMB = borderline myocarditis
9	Case report, Germany[66]	Parvovirus B19	EMB + PCR	EMB = inflammatory cardiomyopathy
10	Author case file, United States	Parvovirus B19	IgM/IgG + blood	Exposure to PVB19 child during pregnancy
11	Author case file, United States	Parvovirus B19 cytomegalovirus	IgG + blood	Hydrops fetus, stillborn
12	Case report, Japan[67]	Influenza A/B	Paired sera antibody rise	EMB = neg. Treatment with IV immunoglobulin
13	Case report, Japan[67]	Influenza B	Paired sera antibody rise	EMB neg. Treatment with IV immunoglobulin
14	Author case file, United States	Parvovirus B19	IgG + blood	Exposure to PVB19 child during pregnancy
15	Author case file, United States	Cytomegalovirus	IgM + blood	LVEF 15%, IgG + blood E-B virus
16	Case report, Taiwan[68]	PCR neg for all 4 tested	EMB/PCR neg, but myocarditis	2 mo pp, RV/LV failure, patient died VF
17	Author case file, United States	H1N1 Influenza	Nasal swab, no Rx given	LVEF 40% at Dx, day 1 postpartum
18	Case report, United States[69]	Parvovirus B19	EMB + PCR	HF 27 wk, g3p2 EMB neg myocarditis
19	Case report, Belgium[70]	E-B virus		Postpartum facial palsy full recovery 6 mo

EMB: Endomyocardial biopsy; PCR: Polymerase chain reaction; LV: Left ventricular; LVEF: LV ejection fraction; PPCM: Peripartum cardiomyopathy; PVB19: Parvovirus B19; RV: Right ventricular; VF: Ventricular fibrillation; HF: Heart failure.