Peripartum cardiomyopathy complicating major postpartum haemorrhage with pre-eclampsia and HELLP syndrome

Peripartum Cardiomyopathy (PPCM) is a rare, potentially life-threatening cause of heart failure, developing in the later stages of pregnancy, or immediately postpartum. Diagnosis can become challenging as obstetric emergencies may provide differing explanations for cardiovascular collapse. We demonstrate a rare case of acute severe biventricular failure occurring very soon after an emergency Caesarean section for a pregnancy complicated by HELLP syndrome in the setting of post-partum pre-eclampsia and severe postpartum haemorrhage. The diagnostic value of an urgent echocardiogram in an obstetric emergency is underlined and the challenges faced by clinicians in managing two serious medical emergencies at the same time are highlighted.