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Pregnancy outcome in a case of non-obstructive hypertrophic cardiomyopathy

A Habib1, T Haque

  • 1Dr Asma Habib, Assistant Professor, Bangladesh Medical College and Hospital, Dhaka, Bangladesh.

Mymensingh Medical Journal : MMJ
|August 29, 2013
PubMed

Insights

Pregnancy in women with hypertrophic cardiomyopathy (HCM) poses risks due to impaired cardiac function. This case highlights severe complications, including preterm delivery and maternal death, emphasizing careful management for hypertrophic cardiomyopathy patients.

Area of Science:

  • Cardiology
  • Genetics
  • Maternal-Fetal Medicine

Background:

  • Hypertrophic cardiomyopathy (HCM) is a common genetic disorder affecting cardiac sarcomere proteins, inherited in an autosomal dominant pattern.
  • Pregnancy presents unique physiological challenges for women with HCM, potentially exacerbating cardiac strain and risks.

Observation:

  • A case of pregnancy co-existing with non-obstructive hypertrophic cardiomyopathy and nodal bradycardia is presented.
  • Physiological changes during pregnancy, including increased cardiac output and vena caval compression, can compromise cardiac function in HCM patients.
  • Labor stress may precipitate arrhythmias, further complicating pregnancy management in women with HCM.

Findings:

  • The pregnancy resulted in preterm delivery and neonatal death.
  • The mother experienced a fatal outcome from overt cardiac failure in the puerperium, despite a relatively uneventful gestation.
  • Non-compliant ventricular walls in HCM can impair the physiological increase in cardiac output during pregnancy.

Implications:

  • This case underscores the significant risks associated with pregnancy in women with hypertrophic cardiomyopathy and co-existing conditions.
  • Careful monitoring and management strategies are crucial for pregnant patients with HCM to mitigate potential life-threatening complications.
  • Further research into the management of pregnancy in HCM patients is warranted to improve maternal and neonatal outcomes.

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