Recovery from Peripartum Cardiomyopathy in a Japanese Woman after Administration of Bromocriptine as a New Treatment Option

Abe, Takashi; Amano, Izuki; Sawa, Rintaro; Akira, Shigeo; Nakai, Asami; Takeshita, Toshiyuki

doi:10.1272/jnms.77.226

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…Bromocriptine is reportedly effective in the treatment of cardiomyopathy [9][10][11][12]. It has been hypothesized that the over-secretion of prolactin increases the quantity of a 16-kDa antiangiogenic prolactin fragment, which may be a key pathological mediator of PPCM through the impairment of myocardial microvacularization [9].…”

Section: Discussionmentioning

confidence: 99%

Bromocriptine use for sudden peripartum cardiomyopathy in a patient with preeclampsia: a case report

et al. 2019

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Background: Peripartum cardiomyopathy is an uncommon form of heart failure that occurs in otherwise healthy women during pregnancy or until 5 months postpartum. Here, we report a rare case where a female patient underwent cesarean section after the occurrence of preeclampsia and intrauterine fetal death, and developed peripartum cardiomyopathy following postsurgical respiratory distress. The prompt initiation of inotropic drug and bromocriptine therapy quickly restored cardiac function. Case presentation: The patient was a 36-year-old woman who underwent emergency cesarean section for a previous preeclampsia and an intrauterine fetal death that occurred after 24 weeks of pregnancy. In addition, the patient had an extremely low platelet count of 5000/μL on admission. She had been diagnosed as idiopathic thrombocytopenic purpura at the age of 29 years old and treated with prednisolone at 15 mg/day. Therefore, the cesarean section was performed under general anesthesia. The patient did not exhibit respiratory or hemodynamic dysfunction during surgery. However, she developed respiratory distress with sinus tachycardia after extubation and was transferred to the intensive care unit. A chest radiograph showed butterfly shadows, and transthoracic echocardiogram confirmed the reduction of left ventricle contractility (ejection fraction 20%). She was diagnosed with peripartum cardiomyopathy and treated immediately with intravenous milrinone, oral bromocriptine, and angiotensin-converting enzyme inhibitor. Respiratory and hemodynamic function improved rapidly, and the patient was moved to the general ward 2 days after surgery. Fourteen days after surgery, the patient had an ejection fraction of 57%. The patient recovered without any further complications and was discharged 24 days after surgery. Conclusion: A sudden case of peripartum cardiomyopathy was successfully managed by a prompt diagnosis and treatment with inotropic agents and bromocriptine.

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Section: Discussionmentioning

confidence: 99%

Bromocriptine use for sudden peripartum cardiomyopathy in a patient with preeclampsia: a case report

et al. 2019

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“…Several recent reports have noted that bromocriptine and prolactin antagonist carbergoline could preserve LV function in PPCM [9]. The treatment of PPCM with bromocriptine was based on the study results that increased oxidative stress could lead to an increased expression and activity of the cathepsin-D, which is responsible for cleaving the 32-kDa form of prolactin to a smaller fragment which possesses antiangiogenic, proinflammatory, and vaso-constrictory properties and could cause dilated cardiomyopathy [1].…”

Section: Discussionmentioning

confidence: 99%

Peripartum cardiomyopathy: a case of patient with triplet pregnancy

Bk¹,

Ćetković²,

Plešinac³

et al. 2016

Clin. Exp. Obstet. Gynecol.

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Peripartum cardiomyopathy (PPCM) is a rare but potentially devastating complication of pregnancy associated with heart failure due to left ventricular systolic dysfunction occurring within the last month of pregnancy and five month postpartum with no obvious other cause of heart failure and no pre-existing heart disease. In the present case report the authors present a woman who developed PPCM on the day after she delivered by cesarean section in 35 th weeks of gestation of triplet pregnancy conceived after ovarian stimulation and insemination. A treatment with diuretics, ACE inhibitors, antiarrhythmics, low weight heparin, antibiotics and bromocriptine was applied and resulted in complete recovery. In conclusion, timely detection and initiation of treatment are important factors for complete recovery of patients with PPCM.

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“…Several case reports have suggested that the addition of bromocriptine to standard heart failure therapy may be beneficial in patients with acute onset PPCM. 42,53–56 A recently published proof-of-concept randomized pilot study of PPCM patients with severely reduced LVEF diagnosed within one month of delivery showed that patients treated with bromocriptine had greater recovery of LVEF and decreased mortality compared with patients receiving placebo. 37 As the use of bromocriptine in the postpartum period is associated with an increased risk of thromboembolism, it is strongly recommended that patients with severely reduced LVEF treated with bromocriptine be anticoagulated.…”

Section: Treatmentmentioning

confidence: 99%

Peripartum cardiomyopathy

Blauwet

Sliwa

2011

Obstet Med

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Summary: Peripartum cardiomyopathy (PPCM) is a potentially devastating disease that affects women during the last months of pregnancy or the first months after delivery. The aetiology and pathogenesis of this disease remain unclear, but oxidative stress and the generation of a cardiotoxic fragment of prolactin may play key roles. Diagnosing PPCM remains a challenge, as symptoms may mimic those women experience during normal pregnancy and the peripartum period. A high index of suspicion is thus necessary to make the diagnosis. Patients with PPCM have a varied clinical course, as some patients achieve full recovery while others progress to end-stage heart failure and even death. Standard heart failure treatment is indicated, although special provisions are necessary in pregnant and lactating women. Additional research into the pathophysiology of this disease, including possible genetic contributions, may lead to novel treatment strategies that can improve outcomes.

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Recovery from Peripartum Cardiomyopathy in a Japanese Woman after Administration of Bromocriptine as a New Treatment Option

Cited by 6 publications

References 24 publications

Bromocriptine use for sudden peripartum cardiomyopathy in a patient with preeclampsia: a case report

Bromocriptine use for sudden peripartum cardiomyopathy in a patient with preeclampsia: a case report

Peripartum cardiomyopathy: a case of patient with triplet pregnancy

Peripartum cardiomyopathy

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