medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2016, Number 08

<< Back

Ginecol Obstet Mex 2016; 84 (08)

Peripartum cardiomyopathy: a case report

Karchmer-Krivitzky S, Espinosa-Fernández R, Sánchez-Aranda A, López-Rioja MJ, Monzalbo-Núñez D

Language: Spanish
References: 19
Page: 542-549
PDF size: 432.90 Kb.


ABSTRACT

Background: Peripartum cardiomyopathy also known as cardiomyopathy associated with pregnancy, is rarely a cause of heart failure, it affects pregnant or puerperal women in the first 5 months. Although the first case reported was in 1849, it was recognized until 1930. In 2010 the European Society of Cardiology Working Group on peripartum cardiomyopathy, defined this pathology as an idiopathic cardiomyopathy that affects pregnant women between the third trimester and five months after delivery. Characterized by a left ventricular failure with an ejection fraction of ≤45% and an end-diastolic dimension ≥2.7 cm/m2, in absence of an identifiable cause of heart failure.
Case Report: We report a case of a 39-year-old patient, diagnosed with a peripartum cardiomyopathy in the early puerperium, characterized by hypertension, tachycardia, dyspnea and oxygen desaturation. The transesophageal echocardiogram reported heart failure, a hypokinetic left ventricle and a ventricular failure with an ejection fraction ‹40%. We could not identify an other cause to justify heart failure. Multidisciplinary management was administered successfully.
Conclusion: The importance of this article relies in the fact that eripartum cardiomyopathy has a high morbidity and mortality. The impact of this pathology is unknow in our country. Here we establish and discuss the multidisciplinary management held in our hospital with this specific patient in order to improve the prognosis on future occasions.


REFERENCES

  1. Sliwa K, Hilfiker-Kleiner D, Petrie MC, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy. Eur J Heart Fail 2010;12:767-778.

  2. European Society of Gynecology (ESG), Association for European Paediatric Cardiology (AEPC), German Society for Gender Medicine (DGesGM), et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur Heart J 2011;32:3147-3192.

  3. Patten I, Rana S, Shahul S, et al. Cardiac angiogenic imbalance leads to peripartum cardiomyopathy. Nature 2012; 485:333-338.

  4. Demakis J, Rahimtoola S. Peripartum cardiomyopathy. Circulation 1971;44:964-968.

  5. Pliego A, Neri E, González J, et al. Peripartum cardiomyopathy: experience at the Central Military Hospital, Mexico. Ginecol Obstet Mex 1997;65:291-295.

  6. Pearson GD, Veille JC, Rahimtoola S, 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;283:1183-1188.

  7. Sliwa K, Böhm M. Incidence and prevalence of pregnancyrelated heart disease. Cardiovasc Res 2014; 101:554-560.

  8. Johnson L, Jensen L, Sobey A. "Peripartum cardiomyopathy: review and practice guidelines." American journal of critical care: an official publication, American Association of Critical-Care Nurses 2012;89:44-50.

  9. Sliwa K, Skudicky D, Bergemann A, et al. Peripartum cardiomyopathy: analysis of clinical outcome, left ventricular function, plasma levels of cytokines and Fas/Apo-1. J Am Coll Cardiol 2000;35:701-705.

  10. Armijo G, Acuña P, Sarango B, et al. Miocardiopatía periparto. Caso clínico. Rev Chil Cardiol 2014;33:67-73.

  11. Sliwa K, Förster O, Libhaber E, et al. Peripartum cardiomyopathy: inflammatory markers as predictors of outcome in 100 prospectively studied patients. Eur Heart J 2006;27:441-446.

  12. Halkein J, Tabruyn P, Ricke-Hoch M, et al. MicroRNA- 146a is a therapeutic target and biomarker for peripartum cardiomyopathy. J Clin Invest 2013;123:2143- 2154.

  13. Nelson JL. Pregnancy, persistent microchimerism, and autoimmune disease. J Am Med Womens Assoc 1998; 53:31-32.

  14. González I, Armada E, Recasens, et al. "Guías de práctica clínica de la Sociedad Española de Cardiología en la gestante con cardiopatía." Revista Española de Cardiología 2000;53:1474-1495.

  15. Okeke T, Ezenyeaku C, Ikeako L. Peripartum Cardiomyopathy. Ann Med Health Sci Res 2013;3:313-319.

  16. Blauwet L, Cooper L. Diagnosis and management of peripartum cardiomyopathy. Heart 2011; 32:3147-3197.

  17. Elkayam U. Clinical characteristics of peripartum cardiomyopathy in the United States: diagnosis, prognosis, and management. J Am Coll Cardiol 2011;58:891-903.

  18. Centers for Disease Control and Prevention (CDC). Update to CDC's U.S. Medical eligibility criteria for contraceptive use, 2010: revised recommendations for the use of hormonal contraception among women at high risk for HIV infection or infected with HIV. MMWR Morb Mortal Wkly Rep 2012;61:449-452.

  19. Safirstein J, Ro A, Grandhi S, et al. Predictors of left ventricular recovery in a cohort of peripartum cardiomyopathy patients recruited via the internet. Int J Cardiol 2012; 154:27-31.




2020     |     www.medigraphic.com