How to Talk to Your Doctor About Peripartum Cardiomyopathy (PPCM)

In those early postpartum days, everything is such a blur. Diaper changes. Latching practice. Sleepless nights. Added to those… in my case were: swelling, breathlessness and excessive fluid retention. I brought these symptoms up to the doctor at the well baby check, but the concerns were brushed off.

"Give it time. Your body’s been through a lot,” were words repeated by everyone around me.

Something in me knew it was more than that. But I didn’t know how to advocate. I didn’t have the words. This post is for anyone in that space… unsure of what’s happening, second-guessing whether it’s “serious enough,” and trying to speak up in a system that often silences maternal concerns.

Why PPCM Is Often Missed and Why That’s Dangerous

Peripartum cardiomyopathy (PPCM) is a form of heart failure that occurs during the final month of pregnancy or within the first five months after giving birth. Because many of its symptoms overlap with common postpartum changes: shortness of breath, swelling, exhaustion, it’s often mistaken for recovery.

Image of a woman explaining symptoms to doctor.

But PPCM is not a slow-moving condition. When left undiagnosed, it can escalate quickly and, in some cases, be fatal. A recent multi-centre study in Québec revealed how little we know about the real scope of this disease in Canada and how urgently we need better detection protocols.

What to Say at Your Appointment

If I could go back to that first appointment – when I felt in my gut something was off, I would have brought this list with me:

Say this clearly:

“I feel breathless lying down or walking across the room.”

“I’m gaining weight quickly and my legs feel tight from swelling.”

“I feel like I’m drowning in my own body some nights.”

“This isn’t how I felt after previous births.”

Ask this directly:

Can we check my heart function with a BNP or NT-proBNP blood test?

Can I get an echocardiogram to assess my heart's pumping ability?

Are you familiar with PPCM or cardio-obstetrics clinics in our area?

These questions are grounded in Canadian guidelines, which recommend BNP/NT-proBNP testing and echocardiography as early diagnostic tools when heart failure is suspected.

Eventually, my symptoms became impossible to ignore – even for the ER. I underwent bloodwork, scans and diagnosed and readmitted within the first week of giving birth. But I often think about how different that story could have been if someone had taken me seriously sooner.

How You Can Approach Things Differently, if You Are Ever in This Position

Show up with written notes of symptoms and timelines.

Have someone with you to speak up if you can’t or feel you need support.

Learn a few key terms: ejection fraction, BNP, PPCM.

Free Resource: 10+ must-ask doctor questions + bonus section

Print this out or keep it in your phone. It includes symptom prompts, test names, and space to note your provider’s responses.

There’s no right script. There’s just your truth.  Even if your voice shakes. Even if you’re still learning what questions to ask. Even if you’ve been brushed off before.

Your body’s signals are not too small to be noticed.

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