ABSTRACT
The sudden onset of heart failure in the puerperium is devastating as it can transform a previously healthy woman to life-threatening illness and a young family from joy to tragedy within days. In less severe cases it has a later and more insidious onset, simulating dilated cardiomyopathy (DCM) except for its temporal relationship to the pregnancy. Although long recognized, the cause was not and still is not fully understood. It was first described in 1937 when it was attributed to ‘idiopathic myocardial degeneration’1 and joined the cardiomyopathies after that neologism was adopted in the 1960s. Myocarditis has been found on endomyocardial biopsy in a high proportion of these patients2,3 and an autoimmune mechanism is likely.4
