Challenges in the diagnosis of peripartum cardiomyopathy: a case series. Issue 2 (16th February 2021)

• Record Type: Journal Article
• Authors: Chirillo, Fabio; Baritussio, Anna; Cucchini, Umberto; Toniolli, Ermanno; Polo, Angela; Iavernaro, Antonio
• Editors: Brown, Richard Alexander; Rudzínski, Piotr Nikodem; Skott-Schmiegelow, Soren; Vágó, Hajnalka; Doolub, Gemina; Ahmed, Nida
• Is Part Of: European heart journal. Volume 5:Issue 2(2021)
• Publication Date: 2021-02-16
• Subjects: Cardiac magnetic resonance imaging -- Case series -- Echocardiography -- Peripartum cardiomyopathy; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytab001
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: Peripartum cardiomyopathy (PPCM) is usually characterized by overt heart failure, but other clinical scenarios are possible, sometimes making the diagnosis challenging. Case summary: We report a case series of four patients with PPCM. The first patient presented with acute heart failure due to left ventricular (LV) systolic dysfunction. Following medical treatment, LV function recovered completely at 1 month. The second patient had systemic and pulmonary thromboembolism, secondary to severe biventricular dysfunction with biventricular thrombi. The third patient presented with myocardial infarction with non-obstructed coronary arteries and evidence of an aneurysm of the mid-anterolateral LV wall. The fourth patient, diagnosed with PPCM 11 years earlier, presented with sustained ventricular tachycardia. A repeat cardiac magnetic resonance, compared to the previous one performed 11 years earlier, showed an enlarged LV aneurysm in the mid-LV anterolateral wall with worsened global LV function. Discussion: Peripartum cardiomyopathy may have different clinical presentations. Attentive clinical evaluation and multimodality imaging can provide precise diagnostic and prognostic information.