SPECIAL OUTPATIENT SERVICE FOR PPCM

In our special outpatient service for peripartum cardiomyopathy (PPCM), the only of its kind nationwide, patients with a pregnancy-associated heart failure are treated and provided with long term care.

Peri- or postpartum heart failure in previously healthy women is a rare but severe heart disease. It can occur without warning in the last month of pregnancy or in the first months after birth. Within a few weeks, the disease can lead to complete heart failure and death.

Symptoms of PPCM include:

  • fatigue
  • shortness of breath
  • cough
  • increase in weight, mainly due to water Retention (oedema) in arms and legs
  • palpitations


Although the symptoms and criteria for PPCM are clearly defined, it is often difficult to detect, as the symptoms mimic those experienced shortly after birth (e.g. fatigue), or overlap with other diseases (e.g. respiratory distress, dry cough and/or water congestion seen in lung x-rays are often mistaken for symptoms of bronchial infections (pneumonia).

Download the scheme for Bromocriptine/Cabergoline treatment of acute PPCM at Hannover Medical School.

Liebe PPCM Patientinnen,

wir verstehen Ihre Sorgen und Ängste in Bezug auf COVID-19.

Leider ist eine individuelle Risikoeinschätzung in der aktuellen Situation für uns schwer möglich, da sich die Faktenlage und die sich daraus ergebenden Empfehlungen fast täglich ändern. Wir verweisen deshalb auf die ständig aktualisierte Risikobewertung des Robert Koch Instituts. https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Risikobewertung.html.

 

PPCM-Patientinnen (insbesondere Patientinnen mit einer eingeschränkten Pumpleistung der linken Herzkammer) sind wie andere chronisch Kranke, einem etwas erhöhten Risiko ausgesetzt und sollten sich entsprechend an den Empfehlungen für Risikogruppen orientieren.

  • Sliwa K, Petrie MC, van der Meer P, Mebazaa A, Hilfiker-Kleiner D, Jackson AM, Maggioni AP, Laroche C, Regitz-Zagrosek V, …, Ponikowski P, Van Veldhuisen DJ, McMurray J, Bauersachs J. Clinical presentation, management and 6-month outcomes in women with peripartum cardiomyopathy, an ESC EORP registry. Eur Heart J. 2020;41(39):3787-3797.
  • Pfeffer TJ, Herrmann J, Berliner D, König T, Winter L, Ricke-Hoch M, Ponimaskin E, Schuchardt S, Thum T, Hilfiker-Kleiner D, Bauersachs J, Kahl, K. Assessment of major mental disorders in a German peripartum cardiomyopathy cohort. ESC Heart Fail. 2020 Sep 10. Doi:10.1002/ehf2.12967.
  • Sieweke JT* , Pfeffer TJ*, Berliner D, König T, Hallbaum M, Napp LC, Tongers J, Kühn C, Schmitto JD, Hilfiker-Kleiner D, Schäfer A, Bauersachs J.  Cardiogenic shock complicating peripartum cardiomyopathy: Importance of early left ventricular unloading and bromocriptine therapy, Eur Heart J Acute Cardiovasc Care 2020; 9(2):173-182.
  • Ricke-Hoch M, Pfeffer TJ and Hilfiker-Kleiner D. Peripartum cardiomyopathy: basic mechanisms and hope for new therapies. Cardiovasc Res. 2020;116(3):520-531.
  • Azibani F*, Pfeffer TJ*, Ricke-Hoch M, Dowling W, Pietzsch S, Briton O, Baard J, Moulig V, König T, Berliner D, Libhaber E, Schlothauer S, Anthony J, Lichtinghagen R, Bauersachs J, Sliwa K#, Hilfiker-Kleiner D#. Outcome in German and South African Peripartum Cardiomyopathy cohorts associates with medical therapy and fibrosis markers. ESC Heart Fail. 2020;7(2):512-522.
  • Bauersachs J, König T, van der Meer P, Petrie MC, Hilfiker-Kleiner D, …, Anker SD, Ponikowski P, Seferovic PM, Johnson MR, Mebazaa A, Sliwa K. Pathophysiology, diagnosis and management of peripartum cardiomyopathy: a position statement from the HFA of the ESC Study Group on peripartum cardiomyopathy. Eur J Heart Fail. 2019;21(7):827-843.
  • Pfeffer TJ*, Schlothauer S*, Pietzsch S, Schaufelberger M, Auber B, Ricke-Hoch M, List M, Berliner D, Abou Moulig V, König T, Arany Z, Sliwa K, Bauersachs J, Hilfiker-Kleiner D. Increased cancer prevalence in peripartum cardiomyopathy. JACC: CardioOncology Vol 1 No.2, 2019.
  • Moulig V*, Pfeffer TJ*, Ricke-Hoch M, Schlothauer S, Koenig T, Schwab J, Berliner D, Pfister R, Michels G, Haghikia A, Falk CS, Duncker D, Veltmann C, Hilfiker-Kleiner D#, Bauersachs J#. Long-term follow-up in peripartum cardiomyopathy patients with contemporary treatment: low mortality, high cardiac recovery, but significant cardiovascular co-morbidities. Eur J Heart Fail. 2019;21(12):1534-1542.
  • Haghikia A, Schwab J, Vogel-Claussen J, Berliner D, Pfeffer T, König T, Zwadlo C, Moulig VA, Franke A, Schwarzkopf M, Ehlermann P, Pfister R, Michels G, Westenfels R, Stangl V, Kühl U, Podewski E, Kindermann I, Böhm M, Sliwa K, Hilfiker-Kleiner D. Bauersachs J. Bromocritine treatment in patients with peripartum cardiomyopathy and right ventricular dysfunction. Clin Res Cardiol. 2019;108(3):290-297.
  • Pfeffer TJ, Hilfiker-Kleiner D. Pregnancy and Heart Disease: Pregnancy-Associated Hypertension and Peripartum Cardiomyopathy, Curr Probl Cardiol. 2018 Sep;43(9):364-388.
  • Thackeray JT, Pietzsch S, Stapel B, Ricke-Hoch M, Lee CW, Bankstahl JP, Scherr M, Heineke J, Scharf G, Haghikia A, Bengel FM and Hilfiker-Kleiner D. Insulin supplementation attenuates cancer-induced cardiomyopathy and slows tumor disease progression. JCI Insight. 2017;2(10):e93098.
  • Duncker D, Westenfeld R, Konrad T, Pfeffer TJ, Correia de Freitas CA, Pfister R, Thomas D, Fürnkranz A, Andrié RP, Napp A, Schmitt J, Karolyi L, Wakili R, Hilfiker-Kleiner D, Bauersachs J, Veltmann C. Risk for life-threatening arrhythmia in newly diagnosed peripartum cardiomyopathy with low ejection fraction: a German multi-centre analysis. Clin Res Cardiol. 2017 Aug;106(8):582-589.
  • Hilfiker-Kleiner D, Haghikia A, Berliner D, Vogel-Claussen J, Schwab J, Franke A, Schwarzkopf M, Ehlermann P, Pfister R, Michels G, Westenfeld R, Stangl V, Kindermann I, Kühl U, Angermann CE, Schlitt A, Fischer D, Podewski E, Böhm M, Sliwa K, Bauersachs J (2017). Bromocriptine for the Treatment of Peripartum Cardiomyopathy: A Multicenter Randomized Study. Eur Heart J. 2017 Sep 14;38(35):2671-2679.
    PDF / Bromocriptin/Caberlogin-Schema

  • Arrigo M, Blet A, Mebazaa A (2017). Bromocriptine for the Treatment of peripartum cardiomyopathy: welcome on BOARD. Eur Heart J. 2017 Sep 14;38(35):2680-2682.
    PDF

Head of unit

Dr. Tobias Jonathan Pfeffer

pfeffer.tobias.j@mh-hannover.de

Contact to the PPCM team of experts
ppcm@mh-hannover.de

Contact and appointments
Tanja Antunovic
Martina Guskau
Zorica Milanovic
Tel.: 0511 532-2532
Fax: 0511 532-9435
kardiologie.ambulanz@mh-hannover.de

(appointments via email)

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