Etiology
PPCM is distinguished from other forms of cardiomyopathies by its occurrence during pregnancy. Precise mechanisms that lead to PPCM remain poorly defined. Many etiological processes have been suggested: viral myocarditis, abnormal immune response to pregnancy, maladaptive response to hemodynamic stresses of pregnancy, stress-activated cytokines, excessive prolactin excretion, and prolonged tocolysis. Also, a familial predisposition to PPCM has been reported. Although underlying genetic variants common to dilated cardiomyopathies are being proposed, a genetic basis specific to PPCM has not been systematically studied. The European Society of Cardiology currently classifies PPCM as a nonfamilial, nongenetic form of dilated cardiomyopathy.