Peripartum cardiomyopathy: a case report and literature review
DOI:
https://doi.org/10.18597/rcog.335Keywords:
peripartum cardiomyopathy, cardiac failure, pregnancyAbstract
Objective: reviewing the relevant literature concerning medical care and management in a peripartum cardiomyopathy (PPCM) high obstetrical dependence unit.
Case report: this article presents a case diagnosed as having PPCM on the 4th day postpartum. An echocardiogram revealed a compromised ejection fraction. Intensive, appropriate treatment led to survival and recovery of left ventricular systolic function.
Discussion: PPCM is a rare cardiac disorder which occurs during the peripartum period. It has been recognised as a distinct entity from myocardial infarction. Its exact incidence remains unknown but mortality rate ranges from 9% to 56%, most deaths being reported during the first three months postpartum. Diagnosis is based upon the clinical presentation of congestive heart failure and objective evidence of left ventricular systolic dysfunction. Treatment should include standard therapy for heart failure, thus implying reduced preload, postload and inotropic, diuretic, vasodilator agents and digoxin use. Angiotensin-converting enzyme inhibitors (ACEI) must be included in CMPP postpartum treatment. The outcome of pregnancy depends on functional state and response to initial treatment. The obstetrician plays a fundamental role in a multidisciplinary approach to females suffering from this entity and must coordinate team efforts.
Author Biographies
Alejandro Hernández-Guzmán
Albaro José Nieto-Calvache
Virna Medina-Palmezano
Especialista en Ginecología y Obstetricia. Universidad del Valle. Profesora Contratista, Departamento de Ginecología y Obstetricia. Universidad del Valle (Cali, Colombia).
Julián Delgado-Gutiérrez
MSc en Obstetricia. Universidad Autónoma de Barcelona (España). Especialista en Ginecología y Obstetricia. Universidad del Valle. Profesor Asistente, Departamento de Ginecología y Obstetricia. Universidad del Valle (Cali, Colombia).
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