Cardiologist in Rajanukunte, Bangalore • post-partum cardiomyopathy This is a cardiomyopathy that by definition develops in the last month of pregnancy or the first five months after delivery. This definition excludes a pre-existing dilated cardiomyopathy exacerbated by pregnancy. Women who already have a reduced ejection fraction usually deteriorate badly in pregnancy and are to be strongly discouraged from becoming pregnant. Treatment with ACE inhibitors and angiotensin receptor antagonists is relatively contraindicated, at least in the second trimester. Patients with peri-partum cardiomyopathy usually improve eventually but may need aggressive treatment including standard heart failure treatment and even ventricular assist devices and transplant. There is a reported 2% mortality risk.22 Patients have a high risk of embolic events even when they are in sinus rhythm and should be anticoagulated. Subsequent pregnancies are associated with a high risk of recurrence,