Cardiomyopathy in pregnancy: 2 case reports.

Area of Science:

• Cardiology
• Obstetrics
• Maternal-Fetal Medicine

Background:

• Peripartum cardiomyopathy (PPCM) is a rare form of heart failure.
• It typically presents in the final month of pregnancy or within five months postpartum.
• Risk factors include advanced maternal age, multiple gestation, and pregnancy-induced hypertension.

Observation:

• Two cases of PPCM in healthy primigravida at 41 and 42 weeks gestation are presented.
• Case 1: Pulmonary edema, cardiac arrest post-admission, Cesarean delivery, second cardiac arrest, and death from DIC and renal failure.
• Case 2: Twin pregnancy with hypertension, Cesarean delivery for fetal distress, postpartum pulmonary edema and left ventricular failure, recovery, and discharge.

Findings:

• PPCM can manifest rapidly and severely, even in previously healthy women.
• Outcomes are variable, ranging from fatal complications to recovery with intensive care.
• These represent the first reported cases of PPCM from Hospital University Sains Malaysia.

Implications:

• Highlights the importance of vigilance for PPCM in late-term pregnancies, even without prior cardiac history.
• Emphasizes the need for prompt diagnosis and aggressive management strategies.
• Suggests a potential underreporting of PPCM, with possible similar cases in existing literature.