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Peripartum cardiomyopathy: an unforeseen catastrophe

Authors:Srivastava Akanksha*, Sharma Rupali, Anand Manpreet
Int J Biol Med Res. 2023; 14(2): 7592-7594  |  PDF File  |  DOI No.: 11.2023-39954192

Abstract

Peripartum cardiomyopathy is a form of congestive cardiac failure which is intimately related to pregnancy. The incidence is 1 in 2500-15000 live births. The patient may become symptomatic in the last month of pregnancy and the signs and symptoms may persist upto 5 months after delivery. PPCM involves systolic dysfunction of the heart with a decrease of the left ventricular ejection fraction (EF) with associated congestive heart failure and an increased risk of atrial and ventricular arrhythmias, thromboembolism (blockage of a blood vessel by a blood clot), and even sudden cardiac death. The cause of PPCM is unknown. Here, we report a case of a 25 year old female, primigravida who presented to the HIMS emergency with complaints of amenorrhoea since 9 months and labour pains since 1 day. Her LMP was 24.10.13 and she had completed 38 weeks and 2 days on the day of admission. On examination, the patient was conscious, pulse rate was 102/min, BP was 120/80 mm hg and she was afebrile. There were petechiae and ecchymotic spots over the skin and gross pedal edema was seen. On per abdomen examination, FH was term size, uterus was irritable, cephalic, FHS was present and regular. On per vaginal examination, os was 1.5 cm dilated, 40% effaced, with vertex at -3 station. Augmentation of labour was done by oxytocin infusion. The patient had to be taken up for emergency LSCS due to meconium stained liquor, delivering an alive male baby . The patient was kept in ICU care and was managed on ionotropes and cardiotonic drugs. 16 units Platelets , 8 units FFP’s and 6 units PRBC’s were transfused during the treatment. The patient was discharged in satisfactory condition on cardio-protective drugs.