Severe preeclampsia, pulmonary edema, and peripartum cardiomyopathy in a primigravida patient.

Peripartum cardiomyopathy (PPCM) is a rare form of heart failure of unknown etiology that is associated with late pregnancy and the early postpartum period. Although the complete pathogenesis of PPCM is not completely understood, the signs and symptoms are identical to those of left ventricular heart failure. The diagnosis of PPCM is made in a parturient only after other causes of heart failure are ruled out. Management of PPCM is similar to that of congestive heart failure with a few exceptions, such as avoiding the use of angiotensin-converting enzyme inhibitors during pregnancy. This report describes the presentation and anesthetic management of a parturient who was admitted with a diagnosis of severe preeclampsia in whom pulmonary edema and heart failure developed, necessitating emergency cesarean delivery under general anesthesia. The patient was subsequently given a diagnosis of PPCM.