Table 7.

Various types of cardiomyopathies in the parturient

Condition	Challenges	Management
Dilated cardiomyopathy	Poor contractility due to dilated chambers after long-standing ischemic heart disease, low ejection fraction, increase in afterload poorly tolerated	CVP-guided fluid administration, inodilator combined with adrenaline to maintain hemodynamics
Hypertrophic cardiomyopathy	Dynamic obstruction of the left ventricular outflow tract (LVOT), vasodilation, hypovolemia lead to low cardiac output and hemodynamic instability	Maintain adequate preload Inotropes are detrimental as they increase LVOT gradient
Restrictive cardiomyopathy	Cardiac output is preload and HR dependant Hypovolemia, atrial arrhythmias may cause hemodynamic instability	Maintain HR and normal rhythm, avoid hypovolemia, arrhythmogenic drugs
Arrhythmogenic RV cardiomyopathy	Extremely high risk of sudden death, ventricular arrhythmias, require automatic implantable cardioverter-defibrillator (AICD) implantation for long-term management	Preferably transfer to critical care unit under the expert care of cardiologist after initial assessment and stabilization