Cardiomyopathy due to valvular heart disease must be identified or ruled out early, since the commonly prescribed supportive therapy may be detrimental in this condition. Acute medical therapy involves reducing preload and afterload with diuretics, nitroglycerin, or nitroprusside, and maintaining inotropic support with dobutamine, dopamine, norepinephrine, and amrinone. Central hemodynamic monitoring is recommended. Chronic oral therapy consists of digoxin, a loop diuretic, and angiotensin-converting enzyme inhibitors. Anticoagulation and antiarrhythmic therapy may also be needed.
Medical therapy is generally palliative, with a diverse response seen among survivors.
Residual cardiopulmonary deficits may remain. In addition, the likelihood of recurrent cardiomyopathy with future pregnancy is great. In general, future prognosis is related to the length of time required for resolution of the cardiac size. Because of this, sterilization for patients with persistent cardiomegaly has been strongly recommended. The advent of intra-aortic balloon counterpulsation was hailed as an important development in the treatment of peripartum cardiomyopathy.