Anaesthetic management of a parturient patient with peripartum cardiomyopathy

Abstract

Peripartum cardiomyopathy (PPCM) is a rare life-threatening clinical entity of unknown aetiology. The hallmark of the disease is the onset of decreased left ventricular ejection fraction either in late pregnancy or puerperium. The clinical presentation and the basic and intensive interventional strategies of the disease are more or less similar to that of dilated cardiomyopathy due to any other cause. Apart from intensive care management, these patients also require anaesthetic intervention for the management of painless labour for either vaginal or operative delivery. Favourable maternal and foetal outcomes require haemodynamic goals to be always kept in mind while choosing the technique and drugs to provide anaesthesia to the patients with PPCM. We report the case of a patient with PPCM requiring emergency lower segment caesarean section who was managed with titrated epidural anaesthesia.

Keywords

• epidural anaesthesia
• ionotropes
• peripartum cardiomyopathy
• pregnancy