Peripartum Cardiomyopathy: Early Diagnosis and Management in Secondary Care Hospital

Abstract

Background: We report a case of Peri-Partum Cardiomyopathy in a 28-year-old Primigravida, who came in labor and underwent a Caesarean Section in view of meconium-stained liquor, fetal distress. On day 4 post-partum, she complained of a sudden onset of shortness of breath, cough, and restlessness in the morning. The patient had no prior history of heart disease or respiratory disease. Patient developed sudden onset tachypnoea and tachycardia with bilateral crepitus. On further evaluation, she was diagnosed with Peripartum Cardiomyopathy. 
Results: The case was successfully managed by a multi-disciplinary team using dobutamine, diuretics, and Angiotensin receptor blockers. 
Conclusion: The case report aims to present a case of Peripartum cardiomyopathy with early diagnosis and successful management in a secondary care level hospital. Peripartum (postpartum) cardiomyopathy is the most common cardiomyopathy in pregnancy, defined as an idiopathic cardiomyopathy that presents with heart failure secondary to left ventricular systolic dysfunction toward the end of pregnancy or after delivery, in the absence of any other cause of heart failure.  It is a diagnosis of exclusion, and the majority are diagnosed postpartum. Although the LV may not be dilated, the ejection fraction is nearly always reduced below 45%. Incidence of PPCM is 1:3000 to 1:15000 pregnancies. It is a major cause of morbidity and mortality if diagnosis gets delayed; therefore, early diagnosis and timely management can affect patients’ long-term prognosis. This case report aims to raise awareness in health professionals about the possibilities of PPCM and its symptoms, as in our case.