Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases, Peripartum cardiomyopathy may also present as “fulminant right ventricular myocarditis”, 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). These drugs should only be started in patients who are euvolaemic and clinically stable. Those data suggest significant differences in presentation and outcome of those two conditions that impact the long‐term management, prognosis and advice about subsequent pregnancy. AIDS, acquired immunodeficiency syndrome; CRP, C‐reactive protein; DCM, dilated cardiomyopathy; ECG, electrocardiogram; HOCM, hypertrophic obstructive cardiomyopathy; HF, heart failure; HIV, human immunodeficiency virus; LE, late enhancement; LV, left ventricular; LVEF, left ventricular ejection fraction; LVOTO, left ventricular outflow tract obstruction; MRI, magnetic resonance imaging; PPCM, peripartum cardiomyopathy; RV, right ventricular; VQ, ventilation–perfusion. Numerous national and international guidelines, including from the World Health Organization, advise that many heart failure drugs are compatible with breastfeeding if used with caution (see online supplementary Table S1). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC, Recommendations on pre‐hospital & early hospital management of acute heart failure: a consensus paper from the Heart Failure Association of the European Society of Cardiology, the European Society of Emergency Medicine and the Society of Academic Emergency Medicine, 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy, A management algorithm for acute heart failure in pregnancy. All patients should remain on a combined drug regimen for heart failure until they experience complete myocardial recovery and for at least 12–24 months after full recovery of LV function.13 Following complete recovery, how long medical therapy should continue is unknown.

Wearable cardioverter‐defibrillators (WCDs) have been proposed as a mechanism to prevent sudden cardiac death during the first 3–6 months after diagnosis until a definitive decision about ICD implantation can be made.4, 41, 80, 81 In a German registry of patients with severe PPCM, several appropriate shocks were delivered for ventricular fibrillation within the first months.41, 80 No randomized trials of WCDs in PPCM have yet been started. ACEI, angiotensin‐converting enzyme inhibitor; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor–neprilysin inhibitor; ESC, European Society of Cardiology; LWMH, low molecular weight heparin; MRA, mineralocorticoid receptor antagonist; NOAC, non‐vitamin K antagonist oral anticoagulant; VKA, vitamin K antagonist. ACEI, angiotensin‐converting enzyme inhibitor; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor–neprilysin inhibitor; LV, left ventricular; LVEF, left ventricular ejection fraction; MRA, mineralocorticoid receptor antagonist; NYHA, New York Heart Association. For treatment of stabilized/chronic heart failure, the pregnancy status of the patient is important. The son of a Nuremberg goldsmith, König was a follower of Adam Elsheimer. How often heart failure in younger women is caused by PPCM will not be determined until there is a large pregnancy cohort study which includes monitoring of cardiac function. Breastfeeding may also confer important benefits to infants and mothers, especially in developing countries. Learn about our remote access options, E-mail address: bauersachs.johann@mh-hannover.de, Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany, Corresponding author. BOARD scheme for the therapy of patients with acute peripartum cardiomyopathy (PPCM).

Tel: +49 511 5323841, Fax: +49 511 5325412, Email: bauersachs.johann@mh-hannover.de, Department of Cardiology, University Medical Center Groningen, Groningen, The Netherlands, Department of Cardiology, Institute of Cardiovascular and Medical Sciences, Glasgow University, Glasgow, UK, Department of Medicine, College of Medicine, University of Lagos, Nigeria, Department of Cardiology, Beirut Cardiac Institute, Lebanon, Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Switzerland, Royal Brompton Hospital and Imperial College London, London, UK, Department of Medicine, Karolinska Institutet and Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden, Heart Failure Unit, Cardiology, G. da Saliceto Hospital, Piacenza, Italy, Department of Cardiology, CARIM School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands, Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology, Leuven, Belgium, The Netherlands Heart Institute, Nl‐HI, Utrecht, The Netherlands, Institute of Emergency for Cardiovascular Disease, University of Medicine Carol Davila, Bucharest, Romania, Division of Cardiology and Metabolism, Department of Cardiology (CVK), Berlin‐Brandenburg Center for Regenerative Therapies (BCRT), German Centre for Cardiovascular Research (DZHK) Partner Site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany, Department of Cardiology, Medical University, Clinical Military Hospital, Wroclaw, Poland, University of Belgrade Faculty of Medicine and Heart Failure Center, Belgrade University Medical Center, Belgrade, Serbia, Department of Obstetrics, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, UK, Department of Anesthesiology and Critical Care Medicine, AP‐HP, Saint Louis Lariboisière University Hospitals, University Paris Diderot, Paris, France, Hatter Institute for Cardiovascular Research in Africa, Department of Cardiology and Medicine, University of Cape Town, Cape Town, South Africa.

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