A Case of Postpartum Pulmonary Edema With Preserved Ejection Fraction and Diastolic Capacity

A 21-year-old female patient delivered vaginally at 40 weeks of gestation after an uneventful pregnancy. She bled profusely during delivery and underwent a blood transfusion and was discharged home on postpartum day 6. On postpartum day 8, she developed respiratory distress and visited our emergency room. She was admitted after a computed tomography scan showed evidence of pulmonary edema; pneumonia was suspected. After admission, her oxygenation worsened, and she was transferred to a higher institution. A PCR test performed at the higher institution was negative for coronavirus disease 2019, and echocardiography showed that the patient's ejection fraction was maintained. Oxygenation improved with oxygen administration alone, and the patient was transferred to our hospital on the same day. Echocardiography performed at our hospital showed no abnormalities in diastolic function, but the left ventricle was enlarged and mild mitral regurgitation was observed. Oxygenation gradually improved with diuretics and oxygen administration, and the patient was discharged home on the fifth day of hospitalization. An echocardiogram performed three months postpartum was normal.