skip to main content

PPCM Recurrence Risk in Pregnancy — EECC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateCardiomyopathyPPCM Recurrence Risk in PregnancyEECC

A 35-year-old woman presents with progressive HF symptoms 4 months postpartum. Echocardiography shows LVEF 22% with global hypokinesis. She is diagnosed with peripartum cardiomyopathy. After 12 months of GDMT, her LVEF recovers to 55%. She asks about future pregnancies. What is the advice?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Subsequent pregnancy carries a significant risk of PPCM recurrence (approximately 20-50%), including life-threatening relapse, even if LVEF has normalised; shared decision-making with detailed counselling is essential

The 2025 ESC CVD in Pregnancy Guidelines and 2023 Cardiomyopathy Guidelines highlight that subsequent pregnancy after PPCM carries a significant recurrence risk of approximately 20-50%, even in women whose LVEF has fully recovered. Recurrence can be severe and life-threatening. Women with persistent LV dysfunction (LVEF <50%) are at highest risk and are generally advised against pregnancy (mWHO IV). Women with fully recovered LVEF can consider pregnancy but must receive comprehensive counselling about recurrence risk, undergo frequent echocardiographic monitoring during and after pregnancy, and have a multidisciplinary pregnancy heart team. Bromocriptine may have a role in reducing prolactin-mediated cardiotoxicity if recurrence is detected early.

Reference: ESC (2025): CVD in Pregnancy Guidelines; ESC (2023): Cardiomyopathies Guidelines