Maternal Health

Heart Problems After Birth (Postpartum Cardiomyopathy)

Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN

Content reviewed against published ACOG, NIH, March of Dimes guidelines

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Your health matters just as much as your baby's. If you are dealing with heart problems after birth (postpartum cardiomyopathy), here is what you need to know.

The short answer

Postpartum cardiomyopathy (PPCM) is a rare but serious form of heart failure that develops in the last month of pregnancy or up to 5 months after delivery. It occurs in approximately 1 in 1,000-4,000 deliveries. Symptoms include severe shortness of breath, persistent swelling, rapid heartbeat, and extreme fatigue beyond normal postpartum tiredness. Early diagnosis and treatment are crucial - most people respond well to heart failure medications.

Key takeaways

  • Postpartum cardiomyopathy (PPCM) is a rare but serious form of heart failure that develops in the last month of pregnancy or up to 5 months after delivery. It occurs in approximately 1 in 1,000-4,000 deliveries. Symptoms include severe shortness of breath, persistent swelling, rapid heartbeat, and extreme fatigue beyond normal postpartum tiredness. Early diagnosis and treatment are crucial - most people respond well to heart failure medications.
  • Usually normal when: Some fatigue and mild swelling in the first weeks after delivery
  • Call your doctor if: Cannot lie flat without difficulty breathing
“About 1 in 8 women experience symptoms of postpartum depression. If you have symptoms of depression that last longer than 2 weeks, tell your health care provider.”
— Depression During and After Pregnancy, Centers for Disease Control and Prevention (CDC)

This is one of the most common questions parents ask. Searching for answers means you care.

What Parents Should Know

According to ACOG, NIH, March of Dimes guidelines, postpartum cardiomyopathy (PPCM) is a rare but serious form of heart failure that develops in the last month of pregnancy or up to 5 months after delivery. It occurs in approximately 1 in 1,000-4,000 deliveries. Symptoms include severe shortness of breath, persistent swelling, rapid heartbeat, and extreme fatigue beyond normal postpartum tiredness. Early diagnosis and treatment are crucial - most people respond well to heart failure medications. At Postpartum, pPCM most commonly presents in the first month after delivery. Key symptoms that distinguish it from normal postpartum recovery include: inability to lie flat without shortness of breath, waking up at night gasping for air, persistent cough, rapid heart rate at rest, extreme fatigue disproportionate to activity level, and rapid weight gain from fluid retention. Risk factors include age over 30, African American descent, multiple pregnancies, history of preeclampsia, and multiparity. With treatment, about 50% of people fully recover heart function within 6 months. It is generally considered normal when some fatigue and mild swelling in the first weeks after delivery. However, you should contact your pediatrician promptly if cannot lie flat without difficulty breathing.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Some fatigue and mild swelling in the first weeks after delivery
Cannot lie flat without difficulty breathing
Shortness of breath that improves with rest
Waking up at night unable to breathe

By Age

What to expect by age

Postpartum

PPCM most commonly presents in the first month after delivery. Key symptoms that distinguish it from normal postpartum recovery include: inability to lie flat without shortness of breath, waking up at night gasping for air, persistent cough, rapid heart rate at rest, extreme fatigue disproportionate to activity level, and rapid weight gain from fluid retention. Risk factors include age over 30, African American descent, multiple pregnancies, history of preeclampsia, and multiparity. With treatment, about 50% of people fully recover heart function within 6 months.

What to Tell Your Pediatrician

  • Describe when you first noticed heart problems after birth (postpartum cardiomyopathy) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if fatigue or shortness of breath that seems excessive compared to other new parents.
  • Mention if swelling that is worsening after delivery rather than improving.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Some fatigue and mild swelling in the first weeks after delivery
  • Shortness of breath that improves with rest
Mention at your next visit when...
  • Fatigue or shortness of breath that seems excessive compared to other new parents
  • Swelling that is worsening after delivery rather than improving
  • Heart palpitations or racing heart at rest
Act now when...
  • Cannot lie flat without difficulty breathing
  • Waking up at night unable to breathe
  • Chest pain or tightness
  • Persistent rapid heartbeat with dizziness or fainting
  • Coughing up frothy or pink sputum

What You Can Do at Home

  • Keep track of when you notice heart problems after birth (postpartum cardiomyopathy) — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that some fatigue and mild swelling in the first weeks after delivery — this is generally within the range of normal.
  • Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
  • While monitoring at home, seek immediate care if cannot lie flat without difficulty breathing.

Heart Issues Around Birth (Peripartum Cardiomyopathy)

Peripartum cardiomyopathy (PPCM) is a rare but serious form of heart failure that can develop in the last month of pregnancy or up to 5 months after delivery. It occurs in approximately 1 in 1,000-4,000 pregnancies. Early recognition and treatment are critical, as most people recover with proper medical care.

Late Postpartum Preeclampsia

Postpartum preeclampsia can develop within 48 hours of delivery or up to 6 weeks after birth, even in people who did not have preeclampsia during pregnancy. It is characterized by high blood pressure and possible organ damage. It is a medical emergency that requires immediate treatment. Knowing the warning signs after delivery is critical.

Guide

Postpartum Recovery Guide

Week-by-week postpartum recovery timeline and warning signs.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is heart problems after birth (postpartum cardiomyopathy) normal?
Postpartum cardiomyopathy (PPCM) is a rare but serious form of heart failure that develops in the last month of pregnancy or up to 5 months after delivery. It occurs in approximately 1 in 1,000-4,000 deliveries. Symptoms include severe shortness of breath, persistent swelling, rapid heartbeat, and extreme fatigue beyond normal postpartum tiredness. Early diagnosis and treatment are crucial - most people respond well to heart failure medications.
When should I call the doctor about heart problems after birth (postpartum cardiomyopathy)?
Cannot lie flat without difficulty breathing Waking up at night unable to breathe Chest pain or tightness
When is heart problems after birth (postpartum cardiomyopathy) normal?
Some fatigue and mild swelling in the first weeks after delivery Shortness of breath that improves with rest
What causes heart problems after birth (postpartum cardiomyopathy)?
Postpartum cardiomyopathy (PPCM) is a rare but serious form of heart failure that develops in the last month of pregnancy or up to 5 months after delivery. It occurs in approximately 1 in 1,000-4,000 deliveries. Symptoms include severe shortness of breath, persistent swelling, rapid heartbeat, and extreme fatigue beyond normal postpartum tiredness. Early diagnosis and treatment are crucial - most people respond well to heart failure medications. Common explanations include: Some fatigue and mild swelling in the first weeks after delivery. Shortness of breath that improves with rest.
What should I mention to my pediatrician about heart problems after birth (postpartum cardiomyopathy)?
You should mention heart problems after birth (postpartum cardiomyopathy) at your next visit if: Fatigue or shortness of breath that seems excessive compared to other new parents. Swelling that is worsening after delivery rather than improving. Heart palpitations or racing heart at rest.
Is heart problems after birth (postpartum cardiomyopathy) normal at Postpartum?
PPCM most commonly presents in the first month after delivery. Key symptoms that distinguish it from normal postpartum recovery include: inability to lie flat without shortness of breath, waking up at night gasping for air, persistent cough, rapid heart rate at rest, extreme fatigue disproportionate to activity level, and rapid weight gain from fluid retention. Risk factors include age over 30, African American descent, multiple pregnancies, history of preeclampsia, and multiparity. With treatment, about 50% of people fully recover heart function within 6 months.
Should I go to the ER for heart problems after birth (postpartum cardiomyopathy)?
Seek emergency care if cannot lie flat without difficulty breathing, or if waking up at night unable to breathe. When in doubt, call your pediatrician's after-hours line for guidance.
Does heart problems after birth (postpartum cardiomyopathy) go away on its own?
In many cases, heart problems after birth (postpartum cardiomyopathy) resolves on its own, especially when some fatigue and mild swelling in the first weeks after delivery.
ACOGNIHMARCH OF DIMES

References

  1. [1]American College of Obstetricians and Gynecologists. Pregnancy and Heart Disease. ACOG Practice Bulletin, 2019. ACOG
  2. [2]National Library of Medicine. Peripartum Cardiomyopathy. StatPearls, 2023. NIH
  3. [3]March of Dimes. Heart Conditions and Pregnancy. March of Dimes, 2023. March of Dimes

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Heart Problems After Birth (Postpartum Cardiomyopathy).

Things to mention

  • Describe when you first noticed heart problems after birth (postpartum cardiomyopathy) and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if fatigue or shortness of breath that seems excessive compared to other new parents.
  • Mention if swelling that is worsening after delivery rather than improving.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Fatigue or shortness of breath that seems excessive compared to other new parents
  • Swelling that is worsening after delivery rather than improving
  • Heart palpitations or racing heart at rest

Urgent signs to report immediately

  • Cannot lie flat without difficulty breathing
  • Waking up at night unable to breathe
  • Chest pain or tightness

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

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Bottom line

Most cases of heart problems after birth (postpartum cardiomyopathy) are normal. Talk to your pediatrician if cannot lie flat without difficulty breathing.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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Late Postpartum Preeclampsia

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