Peripartum cardiomyopathy. Presentation of a case

Abstract

Introduction: peripartum cardiomyopathy is a potentially very serious disease that presents as left ventricular systolic dysfunction with symptoms and signs of heart failure that appears in the last month of pregnancy or within the first 6 months postpartum, in the absence of previous heart disease.
Case presentation: 26-year-old patient with black skin color and health history: obstetric history of 4 pregnancies, 2 abortions and 2 deliveries by caesarean section due to preeclampsia and after 26 weeks presented arterial hypertension, treated with 3 tablets daily of methyldopa, control was achieved. At 8 hours after the elective cesarean section, he presented symptoms of systolic heart failure according to the criteria of postpartum cardiomyopathy, the echocardiogram reported globally depressed left ventricular contractility with ejection fraction between 26 and 27 %, required intensive surveillance, intensive treatment and work multidisciplinary, applying the protocolized treatment with favorable evolution.
Conclusions: peripartum cardiomyopathy was presented as acute pulmonary edema that progressed to cardiogenic shock; as an etiological theory, the autoimmune response of the disordered mother to fetal antigens or cardiotoxic effects of prolactin, factors associated with preeclampsia and skin color. This is a clinical entity with a very low incidence that occurs in the form of heart failure. Echocardiography is important, but the anamnesis and a careful physical examination are the best weapons that clinicians, obstetricians and intensivists have to reach a correct diagnosis.