Peripartum Cardiomyopathy Leading to Multiorgan Dysfunction in a Previously Healthy 30-Year-Old Puerto Rican Woman

Peripartum cardiomyopathy (PPCM) is a rare and potentially life-threatening cause of systolic heart failure that usually arises in the late stages of pregnancy or the early postpartum period. Its clinical presentation can range from moderate symptoms to severe forms of heart failure, such as cardiogenic shock. However, there is scarce data on severe forms of PPCM leading to multiple organ dysfunction and its management. We report a case of a 30-year-old G2P2 previously healthy Puerto Rican woman postpartum day #56 who presented to our Institution with respiratory symptoms. Further evaluation confirmed cardiogenic shock with ischemic hepatitis and acute kidney injury. Echocardiography revealed a dilated left ventricle with an ejection fraction of less than 20%, which suggested PPCM. This case highlights severe manifestations of PPCM, its challenges in management, and the importance of considering it in the differential diagnosis of respiratory symptoms during the peripartum period.