Successful Management of Peripartum Cardiomyopathy in a 29-year-old Woman

Introduction: Peripartum Cardiomyopathy (PPCM), a rare yet life-threatening disease, is defined as an idiopathic cardiomyopathy due to left ventricle (LV) systolic dysfunction without any other cause of heart failure. It occurs in the last month of pregnancy or within 5 months after delivery. The diagnosis is commonly delayed due to resemblance of symptoms with the normal pregnancy or postpartum condition. Here, we highlight the importance of recognizing the early symptoms of PPCM.Case Presentation: A 29-year-old woman was admitted to emergency department with manifestation of heart failure that had lasted for 2 days. There was a history of delivery about 40 days ago. Physical examination showed sign of shock, regular heart rhythm, rhonchi in bilateral basal of lung, mild hepatomegaly, and generalized edema. Laboratory result demonstrated elevation of liver transaminase levels. Chest X-Ray had feature of cardiomegaly while echocardiography finding showed reduction of LV systolic function, global hypokinetic, dilatation of LV, and minimal pericardial effusion. The patient was managed with optimal preload reduction. Afterwards, aldosterone antagonist, anticoagulant, and bromocriptine were given immediately. Clinical symptoms improved and the patient was discharged on the 4th day of hospitalization with the planning of echocardiography re-evaluation regularly. Discussion: PPCM mortality rate ranges widely which is about 7%-50%. Common misdiagnosed or delayed PPCM would be potentially lethal for mother and the baby. Thus, multidisciplinary patient care is highly recommended aiming for heart failure symptoms treatment prior to targeted therapies.Conclusion: Early recognition and management should be addressed properly to achieve favorable outcome.