Peripartum cardiomyopathy - A case report and concise review

Peripartum cardiomyopathy (PPCM) is a rare, but life-threatening disease, which affects women in the last month of pregnancy or in the first 5 months after delivery. Its incidence is variable, ranging from 1 in 1300 to 1 in 15,000 pregnancies and is more prevalent in Haiti and certain parts of Africa. Risk factors include multiparity, advanced maternal age, multiple pregnancies, pre-eclampsia, chronic hypertension, smoking, alcoholism, malnutrition, and long-term tocolysis. Our case report describes a case of a patient, who was admitted for shortness of breath rapidly worsening into asthma cardiale closely after spontaneous delivery. As the cause of the symptoms was diagnosed as heart failure due to peripartum cardiomyopathy, the treatment was symptomatic by diuretics, inotropes, beta-blockers and ACEIs. The mechanical cardiac support was not required. The signs of heart failure subsided within 3 weeks, and in the subsequent period, the left ventricular ejection fraction turned to its previous level as well. This positive state lasted during the 2-year follow-up till now. Diagnostic, treatment and prognosis of peripartum cardiomyopathy are discussed in this article.