Idiopathic myocardial failure in the last trimester of pregnancy and the puerperium.

Instances of congestive heart failure due to unexplained myocardial disease are not infrequently discussed in the literature. The present study, an extension of a similar study reported by Hull in 1937. relates this type of case to the terminal aspects of pregnancy and the puerperium with an incidence of 1 in 1300 deliveries. Four case reports with necropsy findings, together with the clinical observations made on a total of 15 cases are presented. The frequency of recurrence of the syndrome with subsequent pregnancies and the predominance in the puerperium of this type of congestive failure over those of the usual etiologies suggests that the relationship to pregnancy is not fortuitous.