Mayr A, Lederer W, Mörtl M, Margreiter J, Hoi M, Hasibeder W, Mutz N
Department of Anaesthesia and Intensive Care Medicine, The Leopold-Franzens-University of Innsbruck, Austria.
Intensive Care Med. 1999 Feb;25(2):223-5. doi: 10.1007/s001340050821.
We report a 29-year-old primigravid who developed cardiac failure following postpartum haemorrhage unresponsive to volume resuscitation and therapy with catecholamines and phosphodiesterase-inhibitors. Transoesophageal echocardiography (TEE) demonstrated left atrial and ventricular dilatation and global left ventricular hypokinesis. No elevation of serum MB-isoenzyme fraction was detected and other organ functions remained stable. Although emergency cardiac transplantation was considered in the presented patient, the institution of intra-aortic counterpulsation was decided on as a first treatment option. Intra-aortic balloon counter-pulsation rapidly improved cardiac function and led to weaning from pharmacological cardiac support within a few days. Mechanical circulatory assist devices can be life-saving in postpartum-haemorrhage-associated cardiac failure.
