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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

MORALES-MARTINEZ, Luis Carlos et al. Congestive heart failure in pregnancy secondary to peripartum cardiomyopathy. Case report. Ginecol. obstet. Méx. [online]. 2022, vol.90, n.12, pp.1000-1009.  Epub Apr 14, 2023. ISSN 0300-9041.  https://doi.org/10.24245/gom.v90i12.5399.

BACKGROUND:

Peripartum heart disease occurs in 1 out of 4000 cases in the United States; currently, its exact origin is unknown, which is why they are called idiopathic. Genetic diseases, immunological problems and heart malformations have been associated, without being certain about the real origin of these pathologies. Peripartum cardiomyopathy is a rare pathology associated with pregnancy and the puerperium, the diagnosis criteria includes: a) Development of heart failure in the last month of pregnancy or in the 5 months after delivery, b) absence of identifiable causes of heart failure, c) absence of demonstrable heart disease prior to the last month of pregnancy and impaired left ventricular function (FEVI less than 45%). The presentation of the case will help to raise awareness about this problem.

CLINICAL CASE:

A 26-year-old female patient coursing second gestation in the 35.4 pregnancy week, who debuts abruptly with signs of congestive heart disease such as cough, edema, tachycardia and arterial hypertension. The pregnancy was solved by cesarean section with a subsequent stay in Intensive Care Unit, an unknown valvular disease was identified by echocardiography, as well as left ventricular failure and decreased FEVI. Finally, a definitive diagnosis of peripartum cardiomyopathy was integrated.

CONCLUSIONS:

Peripartum heart disease is a rare occurrence, with well-defined clinical pictures, but difficult to approach and diagnose. Where valvular heart disease is the last differential diagnosis for peripuerperal congestive heart disease, and few cases associated with peripartum cardiomyopathy have been described.

Keywords : Congestive heart failure; Valvular disease; Mitral regurgitation; Peripartum cardiomyopathy; Differential diagnosis.

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