Divya Sethi, Naveen Kumar

Department of Anesthesia and Critical Care, Employees’ State Insurance Postgraduate Institute of Medical Sciences and Research, New Delhi, India

Keywords: Echocardiography, parturient, peripartum cardiomyopathy, preeclampsia, respiratory distress

Abstract

Peripartum cardiomyopathy (PPCM) is a rare disease of unknown cause that affects women of childbearing age. A high index of suspicion should be maintained in the pregnant and peripartum woman who presents with sudden cardiac decompensation without any prior history of cardiac disease. The diagnosis can be confirmed with echocardiographic evidence of global left ventricular dysfunction. Timely diagnosis and institution of therapy for heart failure can avoid adverse outcomes in a parturient with PPCM. In this case report, we describe the management of primigravida presenting to the hospital’s emergency department with acute cardiac failure and respiratory distress due to PPCM. The case also highlights that though preeclampsia and PPCM are two separate entities, these can coexist in the same parturient due to the common pathophysiological mechanism. In the review, the recommended medical management of heart failure in PPCM with the “BOARD” (Bromocriptine, Oral heart failure drugs, Anticoagulants, Vasorelaxing agents, and Diuretics) scheme is discussed.

Author Contributions

Literature search and manuscript preparation was done by NK. Concept, design, manuscript editing, and final review of the manuscript was done by DS.

Divya Sethi takes responsibility for the integrity of the work and acts as a guarantor.

Conflict of Interest

None declared.

Financial Disclosure

None declared.