Peripartum cardiomyopathy (PPCM) is a life-threatening heart disease in which a pregnant or postpartum woman’s heart becomes weakened and enlarged. It can strike without warning, usually in the last month of pregnancy or in the months after the baby is born. In South Africa, one in 1000 pregnant women are affected, which is higher than the global average. Professor Karen Sliwa, director of the Cape Heart Institute and a senior cardiologist in the Division of Cardiology, Department of Medicine, and her team, have been making major strides in the treatment and understanding of PPCM.

“While PPCM can vary in terms of severity, mortality rates can be as high as 20%, meaning one in five women succumb to this condition,” said Professor Sliwa. “This despite the young age of the patients.

The risk factors of PPCM are complex and multifactorial. Genetics plays a large role and so too does maternal age, with very young mothers and mothers of advanced maternal age at a higher risk. While the causes of PPCM are still poorly understood, work by Professor Sliwa and her team at the Cape Heart Institute have shown that it relates to the production of prolactin, a breastfeeding hormone. Pregnant women will begin producing prolactin early in pregnancy, with levels rising during the pregnancy to prepare the body for lactation. Women who develop PPCM produce an abnormal form of prolactin which leads to a narrowing of the blood vessels and can ultimately damage the heart.

The Cape Heart Institute is Africa’s leading centre for research on cardiac disease in pregnancy, including PPCM. A multi-professional team from the fields of cardiology, obstetrics, anaesthesia and neonatology care for those women at Groote Schuur Hospital. The disease is not only treated at the clinic but is also one of its research focuses with one of the world's largest PPCM registries with data and biomaterials from more than 700 patients.

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