Peripartum cardiomyopathy (PPCM) is a rare but serious heart condition that can develop in the last month of pregnancy or within the first five months after giving birth. It involves weakening of the heart muscle, making it harder for the heart to pump blood effectively, without another clear cause.
Many women experience common pregnancy and early motherhood symptoms like breathlessness, swelling in the legs or feet, tiredness, or palpitations. In PPCM, these can become more severe or persistent and may signal something that needs urgent medical attention.
Cardiac disease remains one of the leading causes of maternal death in the UK, and reports have shown that delays in recognising symptoms can contribute to poorer outcomes.
Why it matters to you
Pregnancy places extra demands on the heart. After birth, the body continues to adjust, and caring for a newborn can make it harder to notice or report changes. Women have described symptoms being attributed to “normal” recovery, anxiety, or tiredness, leading to multiple contacts with services before a proper assessment. Recovery is possible for many – around 70% regain much of their heart function within a year – but early recognition improves chances.
What to look out for and when to seek help
Contact your midwife, GP, or emergency services if you have:
- New or worsening shortness of breath, especially at rest or when lying flat.
- Persistent coughing, particularly at night.
- Swelling that worsens or affects daily activities.
- Rapid or irregular heartbeat, chest discomfort, or extreme fatigue that feels different from usual postnatal tiredness.
These symptoms can overlap with other conditions such as pulmonary embolism, infection, or anaemia, so a full assessment is important. Do not hesitate to return if symptoms continue or worsen, even if seen before.
You know your body best, especially in the exhausting early weeks with a new baby.
Support and recovery
Diagnosis often involves an echocardiogram (heart ultrasound), ECG, blood tests, and review by specialists. Treatment is tailored and may include medicines safe in pregnancy or breastfeeding where needed. Multidisciplinary teams, including cardiologists and obstetricians, support care through Maternal Medicine Networks.
Many women recover well with prompt care, but some need longer-term heart support. Follow-up is essential, and future pregnancy planning should involve specialist advice due to recurrence risk.
Equity considerations
UK data show higher maternal mortality risks for Black women and those born outside the UK. Language support, cultural understanding, and accessible information help ensure concerns are heard.
This article forms part of the Women’s Health Inquiry Project series. Related topics include maternal cardiac disease in pregnancy, postnatal care transitions, and listening to women’s concerns.
References
- Cardiomyopathy UK. Peripartum cardiomyopathy. Available at: https://www.cardiomyopathy.org
- MBRRACE-UK. Saving Lives, Improving Mothers’ Care reports. Available at: https://www.npeu.ox.ac.uk/mbrrace-uk
- NICE guidance on acute heart failure and related conditions. Available at: https://www.nice.org.uk
- NHS England. Maternal Medicine Networks. Available at: https://www.england.nhs.uk
- European Society of Cardiology and UK resources on PPCM management.
Mandatory disclaimer
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© 2026 Women’s Health Inquiry Project (WHIP). This article includes original analysis of material from publicly available national sources. It may not be reproduced without permission.