What is peripartum cardiomyopathy?

‍Peripartum cardiomyopathy, or PPCM, is a condition where the heart muscle weakens and changes shape during the last months of pregnancy or within the months following birth. When this happens, the heart's main pumping chamber — the left ventricle — becomes enlarged and less able to pump blood effectively around the body. This can cause fluid to build up in the lungs and other parts of the body, leading to breathlessness, swelling and fatigue.

‍PPCM can affect women who have had no previous heart problems. It is rare, but it is a serious condition, and one that is sometimes missed or mistaken for the normal exhaustion of late pregnancy or the postpartum period.

Who does it affect?

PPCM can occur in any woman during late pregnancy or after birth, though certain factors have been associated with a higher likelihood, including:

• High blood pressure during pregnancy, including pre-eclampsia

• Older maternal age

• Multiple pregnancies (twins, triplets)

• Having had multiple previous pregnancies

• A family history of cardiomyopathy

‍ The exact cause of PPCM is not fully understood, and it can occur without any of these factors present.

Signs and symptoms

‍The symptoms of PPCM can be easy to overlook in the context of late pregnancy or new parenthood, since many of them overlap with how pregnancy and recovery normally feel. This is part of why awareness matters.

‍ Symptoms can include:

• Shortness of breath, particularly when lying flat or with only mild exertion

• Unusual or extreme fatigue that feels disproportionate

• Swelling in the legs, ankles or feet

• Palpitations or a racing heartbeat

• Chest pain or discomfort

• A persistent cough

• Abdominal discomfort

If you are experiencing breathlessness, chest pain or symptoms that feel genuinely disproportionate — not just tired, but struggling to breathe — seek medical attention promptly. If symptoms are severe or come on suddenly, call 000.

Treatment and recovery

‍Treatment for PPCM focuses on supporting the heart while it recovers and relieving symptoms. Because some medications affect the baby, treatment can differ depending on whether PPCM occurs during pregnancy or after birth — your medical team will guide what is appropriate for your specific situation.

‍The outlook for PPCM is genuinely encouraging for many women. Around half of women with PPCM recover to normal or near-normal heart function, particularly with early diagnosis and treatment. Some women continue to have reduced heart function afterward, and all subsequent pregnancies following a PPCM diagnosis need to be carefully managed with a team that includes both cardiology and obstetric support.

‍Recovery is individual, and your cardiologist is best placed to talk you through what it looks like for you specifically. ‍

How exercise physiology supports PPCM recovery

Returning to movement after PPCM requires a careful, individualised approach — one that accounts for your heart's current function, your stage of recovery, and the additional demands of new parenthood. Our approach includes:

• Individually prescribed exercise that respects your cardiac history, treatment and medical guidance

• A gradual, carefully staged return to movement, once you have been medically cleared

• Attention to fatigue management and pacing, which are particularly relevant in the postpartum period

• Ongoing review and adjustment as your recovery and heart function progress

• A collaborative approach with your cardiology team, so your exercise plan aligns with your broader care

We offer this support through 1:1 Exercise Physiology— in person at Bondi Junction, Sydney, or via telehealth wherever you are in Australia.