Congestive Heart Failure Stage IV Secondary to Post Partum Cardiomyopathy

V. PATHOPHYSIOLOGY
Postpartum Cardiomyopathy is a type of dilated cardiomyopathy that occurs during pregnancy or after pregnancy. In order for us to understand how this disease came about, we must first understand what happens during pregnancy. During the latter weeks of pregnancy, proteins from the uterine muscles leak into the mothers bloodstream. In some cases, these proteins trigger the immune system of the mother to produce antibodies against it. These proteins are similar to the proteins that make the heart contract. Therefore, the antibodies then attack the heart cells causing the chambers to dilate and the myocardium to weaken. Increase blood volume during pregnancy also contributes to the further weakening of the heart muscle. Dilation often occurs in the left ventricle because this chamber has the most load. When the left ventricle dilates, the heart muscle starts to weaken causing poor ventricular contraction. Blood pools into the ventricle due to a weak contraction and when this happen, the left ventricle gets congested which leads to a backflow to the left atrium which later causes pulmonary congestion. This is evidenced by the clients coughing of a blood tinged sputum. Another complication that happens is a decrease in cardiac output. The heart compensates by increasing its pumping rate but even though the heart rate is increased, it is still not able to distribute blood efficiently. Inadequate blood circulation causes pallor to the extremities, clubbing of the nails, and easy fatigability. The lungs compensate for the decrease in oxygen supply by increasing the respiratory rate of the client.

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Congestive Heart Failure Stage IV Secondary to Post Partum Cardiomyopathy

Postpartum Cardiomyopathy is usually reversible in half of cases. However, advanced stages of this disease process causes Congestive Heart Failure which may become irreversible. In our case, the client is now at her Class IV Congestive Heart Failure which is the presence of her symptoms despite of rest. Cardiac transplantation is the option for treatment.

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Congestive Heart Failure Stage IV Secondary to Post Partum Cardiomyopathy

PATHOPHYSIOLOGY DIAGRAM
Risk Factors: Risk Factors that the Patient have: - Pregnancy
- Heart valve problems - myocarditis -smoking - alcoholism - Pregnancy - malnourishment - hemachromatosis - Hypertension

Proteins from the uterine wall leak into the blood stream during the later weeks of pregnancy

Blood Volume to accommodate infant Preload Left Ventricle starts to dilate over time

Immune system produces antibodies that acts against these proteins

These proteins are the same as the proteins that makes the heart contract

Myocardium weakens Heart is unable to pump adequate blood towards the rest of the body heart rate and respiratory rate as a compensation

Antibodies attacks heart cells

Pooling of blood in the ventricle causing congestion

Blood back flows into the left atrium Pulmonary Congestion

Some blood is retained in the heart due to an inability to overcome the afterload

Clinical Manifestations: Congestive Heart Failure Inadequate Blood Circulation - hemoptysis - Pallor on the extremities - Clubbing of the nails - Easy fatigability - Easy fatigablititykjkjkjkjkjkjk 32