Sethi Divya, Kumar Naveen
Department of Anesthesia and Critical Care, Employees' State Insurance Postgraduate Institute of Medical Sciences and Research, New Delhi, India.
Turk J Emerg Med. 2020 Oct 7;20(4):202-205. doi: 10.4103/2452-2473.297467. eCollection 2020 Oct-Dec.
Peripartum cardiomyopathy (PPCM) is a rare disease of unknown cause that affects women of childbearing age. A high index of suspicion should be maintained in the pregnant and peripartum woman who presents with sudden cardiac decompensation without any prior history of cardiac disease. The diagnosis can be confirmed with echocardiographic evidence of global left ventricular dysfunction. Timely diagnosis and institution of therapy for heart failure can avoid adverse outcomes in a parturient with PPCM. In this case report, we describe the management of primigravida presenting to the hospital's emergency department with acute cardiac failure and respiratory distress due to PPCM. The case also highlights that though preeclampsia and PPCM are two separate entities, these can coexist in the same parturient due to the common pathophysiological mechanism. In the review, the recommended medical management of heart failure in PPCM with the "BOARD" (Bromocriptine, Oral heart failure drugs, Anticoagulants, Vasorelaxing agents, and Diuretics) scheme is discussed.
围产期心肌病(PPCM)是一种病因不明的罕见疾病,影响育龄妇女。对于出现心脏突然失代偿且无任何心脏病史的妊娠和围产期妇女,应保持高度怀疑。通过超声心动图显示的全心左心室功能障碍可确诊。及时诊断并对心力衰竭进行治疗可避免患有PPCM的产妇出现不良后果。在本病例报告中,我们描述了一名初产妇因PPCM出现急性心力衰竭和呼吸窘迫而到医院急诊科就诊的处理情况。该病例还强调,虽然子痫前期和PPCM是两个不同的病症,但由于共同的病理生理机制,它们可在同一产妇中并存。在综述中,讨论了采用“BOARD”(溴隐亭、口服心力衰竭药物、抗凝剂、血管舒张剂和利尿剂)方案对PPCM心力衰竭进行推荐的药物治疗。