Peripartum cardiomyopathy-diagnosis, management, and long term implications

Stergiopoulos, Kathleen; Lima, Fabio V.

doi:10.1016/j.tcm.2018.07.012

Cited by 41 publications

(42 citation statements)

References 63 publications

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“…As more than 50% of women with PPC recover LV function ( 39 , 40 ), the patients reported in the aforementioned studies who did not fully recover postpartum, especially given the fact that there were no antepartum echocardiographic data, might have had latent, asymptomatic LVNC with deterioration in the LV function due to pregnancy. In our case report, the mother showed similar clinical manifestations; however, she was known to have ILVNC since 11 years old, which demonstrates that the decompensation of LVNC can mimic PPC.…”

Section: Discussionmentioning

confidence: 99%

Different Manifestations in Familial Isolated Left Ventricular Non-compaction: Two Case Reports and Literature Review

et al. 2020

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Left ventricular non-compaction (LVNC) is a form of cardiomyopathy characterized by prominent trabeculae and deep intertrabecular recesses which form a distinct "non-compacted" layer in the myocardium. It results from intrauterine arrest of the compaction process of the left ventricular myocardium. Clinical manifestations vary from asymptomatic to heart failure (HF), arrhythmias, or thromboembolic events. We present a case of mother and son diagnosed with isolated LVNC (ILVNC). A 4years-old male patient, diagnosed at 3 months with ILVNC, and NYHA functional class IV HF, was admitted to the Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures, Romania, for cardiologic reevaluation, and diagnosis confirmation. ILVNC was confirmed using echocardiography, revealing a non-compaction to compaction (NC/C) ratio of > 2.7. His evolution was stationary until the age of 8 years, when severe pneumonia caused hemodynamic decompensation, and he was listed for heart transplantation (HT). The patient underwent HT at the age of 11 years with favorable postoperative outcome. Meanwhile, a 22-years-old female patient, mother of the aforementioned patient, was also admitted to our institute due to severe fatigue, dyspnea, and recurrent palpitations with multiple implantable cardioverter defibrillator (ICD) shock delivery. Extensive medical history revealed that a presumptive ILVNC diagnosis was established when she was 11 years old. She was asymptomatic until 18 years old, when 3 months post-partum, she developed NYHA functional class III HF, and subsequently underwent ICD implantation. Her diagnosis was confirmed using multi-detector computed tomography angiography, which revealed a NC/C ratio of > 3.3. ICD adjustments were carried out with a favorable evolution under chronic drug therapy. The last evaluation, at 27 years old, revealed that she was in NYHA functional class II HF. In conclusion, ILVNC, even when familial, can present different clinical pictures and therefore requires different medical approaches.

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Section: Discussionmentioning

confidence: 99%

Different Manifestations in Familial Isolated Left Ventricular Non-compaction: Two Case Reports and Literature Review

et al. 2020

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“…In critically ill pregnant women, norepinephrine is a first-line agent for vasopressor support, although dopamine and dobutamine are alternatives in a low output state ( 5 , 10 ). In terms of mechanical support, intra-aortic balloon pump, LV assist devices, and extracorporeal membrane oxygenation have been used successfully in patients with low-output cardiogenic shock as a bridge to either recovery or transplant ( 2 , 3 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…Decisions regarding the timing and mode of delivery require a multidisciplinary approach with accurate hemodynamic measurements. Although cesarean delivery is not required in all patients with PPCM, approximately 43% PPCM deliveries are via cesarean section ( 10 ). Vaginal delivery is preferred unless there is an obstetric emergency or hemodynamic contraindications indicating cardiac inadequacy or instability when attempting to meet the increase in preload/CO ( 1 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

Recurrent and Life-Threatening Peripartum Cardiomyopathy

et al. 2020

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Peripartum cardiomyopathy is an idiopathic reduction in left ventricular systolic function (ejection fraction <45%) toward the end of pregnancy or in the months after delivery. A multidisciplinary approach to management with shock team support is key to identifying and adequately treating patients with refractory heart failure and peripartum cardiomyopathy. ( Level of Difficulty: Intermediate. )

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“…Risk factors associated with PPCM are increasing age, multiparity, smoking, alcoholism, preeclampsia, eclampsia, geneticpredisposition, and poor socioeconomic background [3][4][5][6]. Surprisingly, most of them are present in our population [6].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Newly Diagnosed Patients of Peripartum Cardiomyopathy at Liaquat University Hospital, Hyderabad, Sindh, Pakistan

Razzaq

Memon

Arain

et al. 2021

JPRI

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Objective: To determine the outcomes of newly diagnosed patients of peripartum cardiomyopathy at Liaquat University Hospital, Hyderabad. Methodology: Total 91 patients of peripartum cardiomyopathy were included. A detailed medical history and base line equitable investigations were done. Patients were kept under observation for 7 days during their hospital stay and study outcomes were recorded. Descriptive statistics were calculated. Stratification was done and post stratification chi square test or fisher exact test was applied. Two sided P-value ≤0.05 was considered as significant. Results: The overall mean age was 29.06±4.71 years. Total 73.6% patients were belonged to urban and 26.4% belonged to rural areas. 52.7% patients had normal delivery while 40% had C-section and 6.6% had instrumental assisted deliveries. As far as outcomes are concerned, 65.9% patients had congestive heart failure, 12.1% patients had arrhythmias, 35.2% patients admitted in ICU, 64.8% patients admitted in recovery and 7.7% patients were died. Conclusion: In a prospective cohort with PPCM, most women recovered; however, rates of CHF were observed significantly in patients with diabetes mellitus and hypertension. In-hospital mortality was comparatively less frequent but it was significantly associated in women having age less than 30 years.

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Peripartum cardiomyopathy-diagnosis, management, and long term implications

Cited by 41 publications

References 63 publications

Different Manifestations in Familial Isolated Left Ventricular Non-compaction: Two Case Reports and Literature Review

Different Manifestations in Familial Isolated Left Ventricular Non-compaction: Two Case Reports and Literature Review

Recurrent and Life-Threatening Peripartum Cardiomyopathy

Outcomes of Newly Diagnosed Patients of Peripartum Cardiomyopathy at Liaquat University Hospital, Hyderabad, Sindh, Pakistan

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