Pregnancy with primary dilated cardiomyopathy.

BACKGROUND

Primary dilated cardiomyopathy is rare in women of childbearing age. The expected increase in intravascular volume and cardiac output during pregnancy is poorly tolerated by patients with primary dilated cardiomyopathy and may result in cardiac failure.

CASE

A primigravid teenager with a history of primary dilated cardiomyopathy developed severe acute cardiac failure at 20 weeks' gestation. She required ventilation and was treated with inotropes and nitroglycerin. After counseling, she underwent termination of pregnancy using misoprostol. She recovered and was discharged 5 days after delivery.

CONCLUSION

Pregnancy in patients with primary dilated cardiomyopathy can be extremely hazardous, resulting in cardiac failure and even death. A multidisciplinary approach and consideration of termination of pregnancy may be required in management of such patients.