Quiz

A 29-year-old P1 L1, reported on postnatal (NVD) day 5 with sudden onset dyspnea and fatigue.She was obese (BMI-31 kg/m 2 ), developed gestational hypertension@35 wks PoG.She was found to be dyspneic and hypoxic with saturation on room air at 89%, BP of 156/88 mm Hg, pulse rate of 90 beats per minute, respiratory rate of 20 breaths per minute.After oxygen through a 4L/min nasal cannula, saturation rose to 95%.Her lungs were clear to auscultation, and her heart rate was regular, with an S3 gallop.No pedal edema and no calf tenderness.Urinalysis results were negative for any proteins.An electrocardiogram showed a normal sinus rhythm.Chest radiographs as shown below. Answer: Peripartum cardiomyopathyDevelopment of cardiac failure in the last month of pregnancy or within 5 months after delivery with the following criteria: Absence of an identifiable cause for the cardiac failure Absence of recognizable heart disease prior to the last month of pregnancy Left ventricular systolic dysfunction is demonstrated by classic echocardiographic criteria.These include depressed ejection fraction or fractional shortening along with a dilated left ventricle.