2024, Number 07
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Med Int Mex 2024; 40 (07)
Peripartum cardiomyopathy associated with pulmonary embolism: an infrequent case
Garnica CCE, Castillo GKA, Chong TJ, Vallejo TJ, Hernández FM, Gómez RJI, Iturralde AVD
Language: Spanish
References: 24
Page: 452-457
PDF size: 232.46 Kb.
ABSTRACT
Background: Cardiovascular diseases strongly impact the quality of life of general
population. One of the most vulnerable populations to these entities are pregnant women
because the physiological changes typical of pregnancy generate hemodynamic stress
that puts at risk the integrity of the mother and the product, predisposing to diseases
such as cardiomyopathy or thromboembolism.
Clinical case: A 23-year-old female patient with a history of 2 pregnancies (one
abortion and one cesarean section). Seven days early she was discharged from the hospital,
after having a cesarean section without eventualities. Two days after her surgery,
she developed dyspnea, cough, and chest pain. Over a period of 5 days her symptoms
worsened and she was readmitted to hospital. She was admitted to the intensive care
unit, treated for acute heart failure. The echocardiogram and chest angiotomography concluded
heart failure with reduced ejection fraction and pulmonary thromboembolism.
Conclusions: The coexistence of peripartum cardiomyopathy and pulmonary
thromboembolism is rare. Timely identification will improve the evolution of these
patients, since confusing them or identifying only one can worsen their prognosis.
REFERENCES
Borhart J, Palmer J. Cardiovascular emergencies in pregnancy.Emerg Med Clin North Am 2019; 37 (2): 339-350.doi:10.1016/j.emc.2019.01.010
Manual de procedimientos estandarizados para la vigilanciaepidemiológica de la notificación inmediata de muertesmaternas. Dirección General de Epidemiología. Secretaríade Salud, 2022.
Rojas-Sánchez AG, Navarro de la Rosa G, Mijangos MéndezJC, Campos Cerda R. Tromboembolia pulmonar en el embarazoy puerperio. Neumol Cir Torax 2014; 73 (1): 42-48.
Garnier Fernández JC, Pizarro Alvarado G, Orozco GarcíaR. Generalidades sobre cardiomiopatía periparto.Revista Médica Sinergia 2021; 6 (7): e687. https://doi.org/10.31434/rms.v6i7.687
Mahmoudi E, Tabary M, Khaheshi I. Pulmonary thromboembolismpresenting with chest pain in a case of peripartumcardiomyopathy. Future Cardiol 2020; 16 (4): 263-269.doi: 10.2217/fca-2019-0029
Bauersachs J, König T, van der Meer P, Petrie MC, et al.Pathophysiology, diagnosis and management of peripartumcardiomyopathy: a position statement from the HeartFailure Association of the European Society of CardiologyStudy Group on peripartum cardiomyopathy. Eur J HeartFail 2019; 21 (7): 827-843. doi: 10.1002/ejhf.1493
Carina Roldán M. Miocardiopatía periparto. Insuf Card2022; 17 (2): 42-60.
Durán-Morales MA, Ariza-Parra EJ. Miocardiopatía periparto:patología potencialmente mortal. Medicas UIS 2016;29 (2): https://doi.org/10.18273/revmed.v29n2-2016009
Konstantinides SV, Meyer G, Becattini C, Bueno H, et al; TheTask Force for the diagnosis and management of acute pulmonaryembolism of the European Society of Cardiology (ESC).2019 ESC Guidelines for the diagnosis and management ofacute pulmonary embolism developed in collaboration withthe European Respiratory Society (ERS): The Task Force for thediagnosis and management of acute pulmonary embolism ofthe European Society of Cardiology (ESC). Eur Respir J 2019;54 (3): 1901647. doi: 10.1183/13993003.01647-2019
Robert-Ebadi H, Moumneh T, Le Gal G, Righini M. Diagnosisof pulmonary embolism during pregnancy. Diagnostics (Basel)2022; 12 (8): 1875. doi: 10.3390/diagnostics12081875
Dado CD, Levinson AT, Bourjeily G. Pregnancy and pulmonaryembolism. Clin Chest Med 2018; 39 (3): 525-537. doi:10.1016/j.ccm.2018.04.007
van der Pol LM, Tromeur C, Bistervels IM, Ni Ainle F, et al;Artemis Study Investigators. Pregnancy-adapted YEARSalgorithm for diagnosis of suspected pulmonary embolism.N Engl J Med 2019; 380 (12): 1139-1149. doi: 10.1056/NEJMoa1813865
Yaméogo NV, Kaboré E, Seghda A, Kagambèga LJ, et al.Embolie pulmonaire grave et ischémie aiguë de membreinférieur compliquant une cardiomyopathie du péripartumtraitées avec succès par thrombolyse à la streptokinase.Ann Cardiol Angéiologie 2014; 65 (1): 38-41. https://doi.org/10.1016/j.ancard.2014.05.016
Agunanne E. Peripartum cardiomyopathy presenting withpulmonary embolism: an unusual case. South Med J 2008;101 (6): 646-7. doi: 10.1097/SMJ.0b013e31816c446d
Lewandowski A, Syska-Sumińska J, Załęska-ZydlewskaI, Grzywanowska-Łaniewska I, et al. Nagłe zatrzymaniekrążenia u pacjentki z kardiomiopatią okołoporodową izatorowością płucną [Patient with sudden cardiac arrest, peripartumcardiomyopathy and pulmonary embolism]. KardiolPol 2013; 71 (7): 741-3. Polish. doi: 10.5603/KP.2013.0163
Fett JD, Carraway RD, Dowell DL, King ME, Pierre R. Peripartumcardiomyopathy in the Hospital Albert SchweitzerDistrict of Haiti. Am J Obstet Gynecol 2002; 186 (5): 1005-10. doi: 10.1067/mob.2002.122423
Hammami R, Mroua F, Ajmi H, Kallel R, et al. Une emboliepulmonaire revelant un syndrome de meadows. Lungembolism revealing post-partum cardiomyopathy. JIMSfax 2017; 26: 53-57.
Janssens U, Klues HG, Hanrath P. Successful thrombolysisof right atrial and ventricle thrombi in a patient with peripartumcardiomyopathy and extensive thromboembolism.Heart 1997; 78 (5): 515-6. doi: 10.1136/hrt.78.5.515
Gershinsky Y, Leibowitz D, Salameh S. A young woman withdyspnea following delivery- cardiomyopathy, pulmonaryembolism or both? Int J Crit Care Emerg Med 2018; 4: 056.DOI: 10.23937/2474-3674/1510056
Agunanne E. Peripartum cardiomyopathy presenting withpulmonary embolism: an unusual case. South Med J 2008;101 (6): 646-7. doi: 10.1097/SMJ.0b013e31816c446d
Jha P, Jha S, Millane TA. Peripartum cardiomyopathycomplicated by pulmonary embolism and pulmonaryhypertension. Eur J Obstet Gynecol Reprod Biol 2005; 123(1): 121-3. doi: 10.1016/j.ejogrb.2005.03.009
Bouhaddoune Y, Hbali A, Aissaoui H, Mrabet A, et al. Peripartumcardiomyopathy: alluring challenge - case seriesand review of literature. Pan Afr Med J 2021; 40 (119).10.11604/pamj.2021.40.119.29168
Lasinska-Kowara M, Dudziak M, Suchorzewska J. Two casesof postpartum cardiomyopathy initially misdiagnosed forpulmonary embolism. Can J Anaesth 2001; 48 (8): 773-7.doi: 10.1007/BF03016693
Toutai C, Kallel O, Houssam L, Ismaili N, Elouafi N.When a peripartum cardiomyopathy patient hidesvarious and serious risk factors for recurrent and fatalthromboembolic events even under well-conductedoral anticoagulation. Cureus 2020; 12 (12): e12392. doi:10.7759/cureus.12392
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