**7. Signs and symptoms**

Signs and symptoms are variable and similar to that in other forms of systolic HF due to cardiomyopathy. Signs include an elevated jugular venous pressure, displaced apical impulse, a third heart sound, and a murmur of mitral regurgitation. Signs and symptoms of systemic or pulmonary thromboembolism may be present. Various studies have reported varying rates of thromboembolism, and further data are required to quantify the risk of this complication. Patients with PPCM left ventricular thrombus were identified by echocardiography in 16 of 100 patients with PPCM (with mean LVEF of 26%) in a case series [2, 21].
