Clinical case of peripartum cardiomyopathy in the third trimester of pregnancy

Abstract

The aim of the work was to study the clinical case of a rare heart disease — peripartum cardiomyopathy.Materials and methods. The puerperal, 34 years old, was admitted to the regional cardiologic dispensary from the regional perinatal center after an emergency cesarean section at 37 weeks of gestation with complaints on short of breath, heaviness in the interscapular region, dyspnea at little exertion and rest, cough with light colored phlegm.Results. Based on anamnesis data (infection at the 22nd week of pregnancy), the clinical picture (symptoms of heart failure from the 36th week of gestation), instrumental research data, a clinical diagnosis was made: Peripartum cardiomyopathy. Echocardiography has become one of the main diagnostic methods that made it possible to verify the diagnosis. Dilatation of the left atrium and left ventricle, reduction of the left ventricular ejection fraction to 40 % and pulmonary hypertension were revealed. The recovery of heart systolic function occurred after 6 months (increasing of the left ventricular ejection fraction up to 58 %).Conclusion. This clinical case is interesting because this rare for Russia disease developed in the third trimester of pregnancy (according to literary data, it often occurs after childbirth). Because of the unstable patient»s condition, an emergency caesarean section was performed, that saved the life of the mother and child. Restoration of heart systolic function occurred after 6 months.

Keywords

• rare disease
• peripartum cardiomyopathy
• etiology
• diagnosis
• echocardiography
• left ventricular ejection fraction
• cardiac insufficiency
• pregnancy
• differential diagnosis
• myocarditis
• prognosis