Although the exact etiology of peripartum cardiomyopathy (PPCM) is still unknown, the inciting factor(s) appears to initiate an inflammatory cardiomyopathy that transitions to an autoimmune or immune dysfunctional process leading to severe heart failure in the peripartum. Early diagnosis and effective treatment, including diuretics, ACE-inhibitors, and beta-blockers, leads to improvement in most and eventual left ventricular systolic recovery in over half of patients. Additional evaluations and potential non-conventional treatments for non-responders may include research protocol use of apheresis, intravenous gamma globulin, immunoadsorption, other immunomodulation therapy, and possible anti-viral therapy.