Meyer Gerd Peter, Labidi Saida, Podewski Edith, Sliwa Karen, Drexler Helmut, Hilfiker-Kleiner Denise
Department of Cardiology and Angiology, MHH, Carl Neuberg Strasse 1, 30625 Hannover, Germany.
J Med Case Rep. 2010 Mar 4;4:80. doi: 10.1186/1752-1947-4-80.
Peripartum cardiomyopathy is a rare form of cardiomyopathy, with heterogeneous presentation occurring in women between one-month antepartum and six months postpartum. It carries a poor prognosis and a high risk of mortality.
We report the development of peripartum cardiomyopathy in two sisters, 27- and 35-year-old African women, one of whom presented with a large left ventricular thrombus. Subsequently, both patients were treated with bromocriptine, heparin and standard therapy for heart failure (angiotensin converting enzyme inhibitors, beta-blockers and diuretics). During follow-up, the left ventricular thrombus observed in one patient degraded. Neither patient experienced a thrombotic event, and both experienced continuous improvements in cardiac function and New York Heart Association stage.
The development of peripartum cardiomyopathy in two sisters indicates that there may be a genetic basis for this type of cardiomyopathy, and that women with a positive family history for peripartum cardiomyopathy may have an increased risk of developing the disease. This is also the first report of a patient experiencing degradation of a large left ventricular thrombus under standard therapy for heart failure with bromocriptine. It suggests that the use of bromocriptine in association with adequate anti-coagulation and heart failure therapy may be beneficial and safe.
围产期心肌病是一种罕见的心肌病形式，表现多样，发生于产前1个月至产后6个月的女性。其预后较差，死亡率高。
我们报告了两名非洲女性姐妹（分别为27岁和35岁）发生围产期心肌病的情况，其中一人出现左心室大血栓。随后，两名患者均接受了溴隐亭、肝素及心力衰竭标准治疗（血管紧张素转换酶抑制剂、β受体阻滞剂和利尿剂）。在随访期间，一名患者观察到的左心室血栓溶解。两名患者均未发生血栓事件，且心功能和纽约心脏协会分级均持续改善。
两名姐妹发生围产期心肌病表明，这种类型的心肌病可能存在遗传基础，有围产期心肌病家族史的女性患该病的风险可能增加。这也是首例关于在心力衰竭标准治疗中联合溴隐亭治疗下大左心室血栓溶解的患者报告。这表明溴隐亭与适当的抗凝及心力衰竭治疗联合使用可能是有益且安全的。
