Peripartum cardiomyopathy: a case report and review of current diagnostic and therapeutic strategies
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20252360Keywords:
Peripartum cardiomyopathy, Postpartum heart failure, Echocardiography, Bromocriptine, Left ventricular dysfunctionAbstract
Peripartum cardiomyopathy (PPCM) is a rare but serious cause of heart failure in late pregnancy or the postpartum period. We report a unique case of PPCM with delayed onset and predominant right-sided heart failure in a 41-year-old woman, presenting on postpartum day 14 with peripheral edema and fatigue. Initial findings, including severe anemia and hypoalbuminemia, obscured the diagnosis. Echocardiography revealed biventricular dysfunction and biatrial enlargement. Treatment with beta-blockers and diuretics led to significant recovery. This case highlights the diagnostic challenge of atypical PPCM and underscores the need for vigilance and cardiac evaluation in postpartum patients with heart failure signs.
Metrics
References
Ben Letdifa D, Slama A, Khemakhem K, Ben Jazia K, M'hamdi S, Jegham H, et al. Cardiomyopathie du péripartum: série de cas cliniques. Ann Fr Anesth Réanimation. 1999;18(6):677-8. DOI: https://doi.org/10.1016/S0750-7658(99)80156-7
Task Force on the Management of Cardiovascular Diseases During Pregnancy of the European Society of Cardiology. Expert consensus document on management of cardiovascular diseases during pregnancy. Eur Heart J. 2003;24(8):761-81. DOI: https://doi.org/10.1016/S0195-668X(03)00098-8
Drissi J, Idri Z, Kouach J, Moussaoui D, Dehayni M. Cardiomyopathie du péripartum [Peripartum cardiomyopathy]. Pan Afr Med J. 2018;29:7. DOI: https://doi.org/10.11604/pamj.2018.29.7.12236
Reimold SC, Rutherford JD. Peripartum cardiomyopaty. N Engl J Med. 2001;344(21):1567- 71. DOI: https://doi.org/10.1056/NEJM200105243442101
Davis MB, Arany Z, McNamara DM, Goland S, Elkayam U. Peripartum Cardiomyopathy: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75(2):207-21. DOI: https://doi.org/10.1016/j.jacc.2019.11.014
Bahloul M, Ben Ahmed MN, Laaroussi L, Chtara J, Kallel H, Dammak H, et al. Peripartum cardiomyopathy: incidence, pathophysiology, clinical manifestations, therapeutic management and prognosis. Ann Franc Anes Réa. 2009;28(1):44-60. DOI: https://doi.org/10.1016/j.annfar.2008.11.001
Hilfiker-Kleiner D, Kaminski K, Podewski E, Bonda T, Schaefer A, Sliwa K, et al. A cathepsin D-cleaved 16 kDa form of prolactin mediates postpartum cardiomyopathy. Cell. 2007;128(3):589-600. DOI: https://doi.org/10.1016/j.cell.2006.12.036
Merson L, Stecken L, Morel N, Lélias A, Dabadie P. Défaillance cardiaque en postpartum: cas clinique d'une cardiomyopathie du péripartum. Annales Françaises d'Anesthésie et de Réanimation. 2008;27(9):731-4. DOI: https://doi.org/10.1016/j.annfar.2008.07.082
Pearson GD, Veille JC, Rahimtoola S, Hsia J, Oakley CM, Hosenpud JD, et al. Peripartum cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institutes of Health) workshop recommendations and review. JAMA. 2000;283(9):1183-8. DOI: https://doi.org/10.1001/jama.283.9.1183
Marmursztejn J, Vignaux O, Goffinet F, Cabanes L, Duboc D. Delayed-enhanced cardiac magnetic resonance imaging features in peripartum cardiomyopathy. Int J Cardiol. 2009;137(3):e63-4. DOI: https://doi.org/10.1016/j.ijcard.2009.04.028
Amos AM, Jaber WA, Russell SD. Improved outcomes in peripartum cardiomyopathy with contemporary. Am Heart J. 2006;152(3):509-13. DOI: https://doi.org/10.1016/j.ahj.2006.02.008
Sliwa K, Blauwet L, Tibazarwa K, Libhaber E, Smedema JP, Becker A, et al. Evaluation of bromocriptine in the treatment of acute severe peripartum cardiomyopathy: a proof-of-concept pilot study. Circulation. 2010;121(13):1465-73. DOI: https://doi.org/10.1161/CIRCULATIONAHA.109.901496
Chapa JB, Heiberger HB, Weinert L, Decara J, Lang RM, Hibbard JU. Prognostic value of echocardiography in peripartum cardiomyopathy. Obstet Gynecol. 2005;105(6):1303-8. DOI: https://doi.org/10.1097/01.AOG.0000161382.30233.ba
Fett JD, Sannon H, Thélisma E, Sprunger T, Suresh V. Recovery from severe heart failure following peripartum cardiomyopathy. Int J Gynaecol Obstet. 2009;104(2):125-7. DOI: https://doi.org/10.1016/j.ijgo.2008.09.017