12-lead Electrocardiogram as a Screening Tool for Peripartum Cardiomyopathy: A Systematic Review

Author : H. Angkasa
Upload Date : 19-04-2018

Background: Peripartum cardiomyopathy (PPCM) is a life threatening condition for both mother and fetus. Early detection and intervention is critical for recovery of ventricular function. Despite paramount importance, there is a lack of standardized screening method for PPCM in limited settings, especially in developing countries with unequal distribution of cardiologists and limited access to echocardiography. Electrocardiogram (ECG) is a simple, low cost screening tool to detect changes in cardiac electrophysiology. Abnormal electrocardiogram has been shown to correlate with PPCM. We scoured the present literature database for evidence of the value of ECG for PPCM screening.

Methods: A comprehensive search was conducted in PubMed and Cochrane database on the 25^th of January 2018, using the following keywords [‘ECG’/’electrocardiogram’ AND ‘PPCM’/‘peripartum cardiomyopathy’]. Appropriate results were selected based on inclusion criterion (English, humans and publication within the last 20 years). Studies with < 20 patients were excluded.

Results: A total of 4 studies were identified. These studies showed that abnormal ECG results are highly correlated with PPCM. However, there is a lack of specific ECG changes in PPCM.

Conclusion: Despite limited evidence, the value of ECG in resource-poor setting should be considered as a routine screening tool for pregnant women. When possible, early gestation or prenatal ECG screening should be conducted to provide baseline ECG report. Abnormal ECG findings should warrant further investigation in hospitals equipped with the necessary echocardiography and cardiologist.

KEYWORDS : electrocardiogram, peripartum cardiomyopathy, screening, PPCM, ECG