Veno-venous ECMO as a safe bridge to recovery in a patient with severe peripartum cardiomyopathy – learning from errors

Perfusion ◽  
2016 ◽  
Vol 32 (4) ◽  
pp. 328-332 ◽  
Author(s):  
Christopher Ull ◽  
Thomas Armin Schildhauer ◽  
Justus T. Strauch ◽  
Andreas Mügge ◽  
Justyna Swol
Keyword(s):  
Heart Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Peripartum Cardiomyopathy ◽  
Unknown Etiology ◽  
Multiparous Woman ◽  
Bridge To Recovery ◽  
Learning From Errors ◽  
Few Data ◽  
European Society Of Cardiology ◽  
In Pregnancy

Peripartum cardiomyopathy (PPCM) is a rare disorder of unknown etiology and pathogenesis. The most important tool for diagnostic confirmation is transthoracic echocardiography. The recommended management of PPCM in pregnancy is summarized by the European Society of Cardiology Heart Failure Guidelines. Few data exist on the treatment of patients with fulminant PPCM and the need for extracorporeal membrane oxygenation (ECMO) in this context. We report on a young multiparous woman with cardiogenic shock caused by severe PPCM who was successfully, but atypically, supported with veno-venous ECMO as a bridge to recovery immediately after the birth of her third child.

Heart Failure in Pregnancy – Another Possibility Beyond Peripartum Cardiomyopathy

2019 ◽  
Vol 32 (3) ◽  
Author(s):  
Antonio José Lagoeiro Jorge ◽  
Deborah Luz Diniz Martins ◽  
Diane Xavier de Ávila ◽  
Otávio Souza de Martino ◽  
Mário Luiz Ribeiro ◽  
...  
Keyword(s):  
Heart Failure ◽  
Peripartum Cardiomyopathy ◽  
In Pregnancy

Challenges of Takayasu Arteritis in Pregnancy: A Case Report

2017 ◽  
Vol 51 (4) ◽  
pp. 195-198 ◽  
Author(s):  
Sarah Soo-Hoo ◽  
Jenny Seong ◽  
Brandon R. Porten ◽  
Nedaa Skeik
Keyword(s):  
Heart Failure ◽  
Takayasu Arteritis ◽  
Cardiovascular Complications ◽  
Unknown Etiology ◽  
Optimal Management ◽  
Women Of Childbearing Age ◽  
Childbearing Age ◽  
Clinical Challenge ◽  
Increased Risk ◽  
In Pregnancy

Takayasu arteritis is a rare, chronic vasculitis of unknown etiology characterized by inflammation of the aorta and its main branches. Although Takayasu arteritis mostly affects women of childbearing age, there is a paucity in the literature on pregnancy associated with Takayasu arteritis. Pregnant patients are at increased risk of cardiovascular complications, including hypertension and congestive heart failure, which may jeopardize both maternal and fetal outcomes. Furthermore, optimal management has not yet been established for pregnant patients with Takayasu arteritis, posing a clinical challenge. We present a case of a young woman with Takayasu arteritis whose symptoms and disease activity improved during 2 pregnancies. Although her first pregnancy was complicated with preeclampsia, gestational diabetes, and preterm vaginal delivery, her second pregnancy was uneventful. This case provides a rare glimpse of Takayasu arteritis in pregnancy and highlights the challenges of medical management in gravid patients.

scholarly journals Cardiomyopathy and pregnancy

Heart ◽  
2019 ◽  
Vol 105 (20) ◽  
pp. 1543-1551 ◽  
Author(s):  
Maria Schaufelberger
Keyword(s):  
Heart Failure ◽  
High Risk ◽  
Right Ventricular ◽  
Dilated Cardiomyopathy ◽  
Ventricular Arrhythmias ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
High Risk Patients ◽  
Risk Patients ◽  
In Pregnancy

Cardiomyopathy is a group of disorders in which the heart muscle is structurally and functionally abnormal in the absence of other diseases that could cause observed myocardial abnormality. The most common cardiomyopathies are hypertrophic and dilated cardiomyopathy. Rare types are arrhythmogenic right ventricular, restrictive, Takotsubo and left ventricular non-compaction cardiomyopathies. This review of cardiomyopathies in pregnancy shows that peripartum cardiomyopathy is the most common cardiomyopathy in pregnancy. Peripartum cardiomyopathy develops most frequently in the month before or after partum, whereas dilated cardiomyopathy often is known already or develops in the second trimester. Mortality in peripartum cardiomyopathy varies from <2% to 50%. Few reports on dilated cardiomyopathy and pregnancy exist, with only a limited number of patients. Ventricular arrhythmias, heart failure, stroke and death are found in 39%–60% of high-risk patients. However, patients with modest left ventricular dysfunction and good functional class tolerated pregnancy well. Previous studies on >700 pregnancies in 500 women with hypertrophic cardiomyopathy showed that prognosis was generally good, even though three deaths were reported in high-risk patients. Complications include different types of supraventricular and ventricular arrhythmias, heart failure and ischaemic stroke. Recent studies on 200 pregnancies in 100 women with arrhythmogenic right ventricular cardiomyopathy have reported symptoms, including heart failure in 18%–33% of pregnancies. Ventricular tachycardia was found in 0%–33% of patients and syncope in one patient. Information on rare cardiomyopathies is sparse and only presented in case reports. Close monitoring by multidisciplinary teams in referral centres that counsel patients before conception and follow them throughout gestation is recommended.

scholarly journals Peripartum Cardiomyopathy: The Hidden Enemy

2021 ◽  
Author(s):  
Fatima Zahra Merzouk ◽  
Sara Oualim ◽  
Mohammed Sabry
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Lv Function ◽  
Close Monitoring ◽  
Mortality And Morbidity ◽  
Life Threatening ◽  
History Of ◽  
The Brain ◽  
In Pregnancy

Peripartum cardiomyopathy (PPCM) is the most common cardiomyopathy in pregnancy. It is potentially life-threatening. It is, diagnosed in women without a history of heart disease 1 month before delivery or within 5 months. It is marked by heart failure and left ventricular dyshfunction. The evolution is favorable. LV function improves within 6 months in the majority of patients, but long-lasting mortality and morbidity are not infrequent. Recent work suggests the critical toxic role for late-gestational hormones on the maternal vasculature and the genetic underpinnings of PPCM. Complications include different types of supraventricular and ventricular arrhythmias, heart failure and ischemic stroke. The brain natriuretic peptide (BNP) can be used to risk stratify women for adverse events. Management of peripartum cardiomyopathy is based on treatment of heart failure. The addition of bromocriptine seemed to improve LVEF. Close monitoring of pregnant women with cardiomyopathy by multidisciplinary team is recommended.

Cardiomyopathies and heart failure

ESC CardioMed ◽  
2018 ◽  
pp. 2870-2872
Author(s):  
Vera Regitz-Zagrosek
Keyword(s):  
Heart Failure ◽  
Hypertrophic Cardiomyopathy ◽  
High Risk ◽  
Maternal Mortality ◽  
Dilated Cardiomyopathy ◽  
Treatment Options ◽  
Peripartum Cardiomyopathy ◽  
New Treatment ◽  
In Pregnancy

Treatment of heart failure in pregnancy is based on the respective guidelines for the treatment of heart failure with some pregnancy-specific limitations. Cardiomyopathies are a rare but serious cause of heart failure and currently the most frequent cause of maternal mortality in pregnancy. All forms of cardiomyopathies may occur in pregnancy but peripartum cardiomyopathy is a specific and dangerous manifestation. Some new treatment options are arising based on its specific pathophysiology. Dilated cardiomyopathy has a high risk of deterioration in pregnancy. In contrast, hypertrophic cardiomyopathy is frequently tolerated well. Delivery should be well planned and some limitations on breastfeeding should be considered.

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