scholarly journals A tale of the broken heart: peripartum cardiomyopathy, a case report

2016 ◽  
Vol 25 (1) ◽  
pp. 57-61
Author(s):  
Hori Hariyanto ◽  
Corry Q. Yahya ◽  
Primartanto Wibowo ◽  
Oloan E. Tampubolon
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Signs And Symptoms ◽  
Decompensated Heart Failure ◽  
Peripartum Cardiomyopathy ◽  
Skin Cool ◽  
Pump Failure ◽  
Airway Control ◽  
Progressive Dyspnea ◽  
Continuous Hemodynamic Monitoring

Progressive dyspnea following childbirth warrants a prompt suspicion into the diagnosis of peripartum cardiomyopathy, PPCM. Pump failure causes an inadequate cardiac output which ultimately contributes to PPCM high mortality rate; however early airway control, vigilant fluid balance and vasoactive support will substantially reduce the incidence of patients falling into decompensated heart failure. More importantly, it is imperative that these patients are cared in a setting where continuous hemodynamic monitoring is available. This case report serves as a reminder not to focus end-point therapy solely on blood pressure readings, but to observe signs and symptoms of hypoperfusion such as cold clammy skin, cool extremities, decreased urine output and mental status.

HEMANGIOMA OF THE LIVER WITH HEART FAILURE: A CASE REPORT

PEDIATRICS ◽  
1954 ◽  
Vol 14 (2) ◽  
pp. 117-121
Author(s):  
ROBERT W. WINTERS ◽  
SAUL J. ROBINSON ◽  
GEORGE BATES
Keyword(s):  
Heart Failure ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Case Report ◽  
Cardiac Hypertrophy ◽  
Cardiac Failure ◽  
Congenital Heart ◽  
Signs And Symptoms ◽  
Post Mortem ◽  
Great Vessels

A case of multiple hemangiomata of the liver is reported in an infant who presented signs and symptoms strongly suggesting congenital heart disease. The post mortem examination revealed no gross anomalies of the heart or great vessels, but did show a heart with cardiac hypertrophy. A mechanism to explain the cardiac failure in this case is discussed.

Case Report: Exercise in a Patient with Acute Decompensated Heart Failure Receiving Positive Inotropic Therapy

2011 ◽  
Vol 22 (2) ◽  
pp. 13-18 ◽  
Author(s):  
Paul E. H. Ricard ◽  
Robert Camarda ◽  
Laura Little Foley ◽  
Michael M. Givertz ◽  
Lawrence P. Cahalin
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Acute Decompensated Heart Failure ◽  
Decompensated Heart Failure ◽  
Inotropic Therapy

scholarly journals Live born recipient of twin–twin transfusion syndrome with anomalous mitral arcade

2019 ◽  
Vol 12 (5) ◽  
pp. e229237
Author(s):  
Siv Steinsmo Ødegård ◽  
Birgitte Kahrs ◽  
Astri Maria Lang ◽  
Siri Ann Nyrnes
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Case Report ◽  
Surgical Treatment ◽  
High Risk ◽  
Fetal Distress ◽  
Decompensated Heart Failure ◽  
Mitral Insufficiency ◽  
Fetal Ultrasound ◽  
Parental Counselling

We present a case report of anomalous mitral arcade in a live born former recipient of twin–twin transfusion syndrome. At 33+0 week of gestation fetal ultrasound demonstrated that she had a large mitral insufficiency, decreased movement of the lateral cusp of the mitral valve and dilated left atrium. The twins were delivered by caesarean section at week 33+1 due to fetal distress. The former recipient twin developed decompensated heart failure during her first day of life and was transferred to a surgical paediatric heart centre. Her clinical condition rapidly deteriorated, and she died of congestive heart failure 3 days old. Prenatal signs of anomalous mitral arcade in a recipient of twin–twin transfusion syndrome should warrant preparation of a critically ill neonate, including parental counselling and in utero transfer to surgical paediatric heart centre. There is a surgical treatment option available for neonates, but the experience with this technique is still very limited with a high risk of morbidity and mortality.

scholarly journals A Change of Heart: Case Series of Peripartum Cardiomyopathy

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Sean Martin ◽  
Daniel Short ◽  
Chih Mun Wong ◽  
Dina McLellan
Keyword(s):  
Heart Failure ◽  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Significant Proportion ◽  
Case Series ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Ventricular Systolic Dysfunction ◽  
Diagnostic Challenge

Peripartum cardiomyopathy (PPCM) is an uncommon disease of pregnancy, occurring in about 1 in 2000 live births, and is characterized by the development of heart failure, due to left ventricular systolic dysfunction. It is associated with high rates of maternal and neonatal mortality. Cardiac disease is the leading cause of maternal death in the UK: PPCM accounts for about 17% of these. Clinical findings of decompensated heart failure (HF) are often masked by the normal physiological changes seen in pregnancy making the diagnosis challenging. A high index of suspicion is essential—prompting referral for echocardiogram, which is crucial for diagnosis. Favourable prognosis is dependent on the early initiation of HF medications. Although full recovery occurs in around half of cases, left ventricular systolic dysfunction persists in a significant proportion of patients with PPCM and the risk of recurrence in subsequent pregnancies is high. The pathophysiology of PPCM is under intense research. We present four patients with PPCM and a review of the literature. Owing to the diagnostic challenge of PPCM and decompensated HF in pregnant mothers and its high mortality rate without treatment, prompt investigation and referral are key to improving maternal survival.

scholarly journals Peripartum Cardiomyopathy: A Review of Three Case Reports

2012 ◽  
Vol 4 (3) ◽  
pp. 164-166 ◽  
Author(s):  
Ankita Kumari ◽  
Mridul Chaturvedi
Keyword(s):  
Heart Failure ◽  
Left Ventricular Systolic Dysfunction ◽  
Case Reports ◽  
Systolic Dysfunction ◽  
Signs And Symptoms ◽  
Left Ventricular ◽  
Peripartum Cardiomyopathy ◽  
Idiopathic Cardiomyopathy ◽  
Maternal Morbidity And Mortality ◽  
Long Term Prognosis

ABSTRACT Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy that presents with heart failure secondary to left ventricular systolic dysfunction toward the end of pregnancy or in the months after delivery. Incidence of PPCM ranges from 1:300 to 1:15,000 pregnancies. Causes and pathogenesis are poorly understood. Clinical presentation includes signs and symptoms of heart failure. PPCM remains a major cause of maternal morbidity and mortality. Many cases of PPCM improve or resolve completely but others progress to heart failure; as early diagnosis and medical treatment may affect the patient's long-term prognosis. The aim of this report is to make health professionals aware of the possibilities in a woman with dyspnoea in the postpartum period. How to cite this article Kumari A, Singh S, Singh S, Chaturvedi M. Peripartum Cardiomyopathy: A Review of Three Case Reports. J South Asian Feder Obst Gynae 2012;4(3):164-166.

scholarly journals What Is High Enough? Elevated NT-pro-BNP in Decompensated Paroxysmal Supraventricular Tachycardia

2017 ◽  
Vol 07 (01) ◽  
pp. 049-053
Author(s):  
Clayton Womack ◽  
L. Lutherer ◽  
Christopher Todd ◽  
Kerrie Pinkney ◽  
Thivakorn Kasemsri ◽  
...  
Keyword(s):  
Heart Failure ◽  
Supraventricular Tachycardia ◽  
Natriuretic Peptide ◽  
Clinical Signs ◽  
Case Series ◽  
Signs And Symptoms ◽  
Decompensated Heart Failure ◽  
Adult Patients ◽  
Cardiac Monitoring ◽  
Paroxysmal Supraventricular Tachycardia

AbstractSince the late 1980s, elevated atrial natriuretic peptide (ANP) was considered the cause of brisk diuresis in adult patients with paroxysmal supraventricular tachycardia (PSVT). Pro-brain natriuretic peptide (pro-BNP) and related molecules, e.g., N-terminal pro b-type natriuretic peptide (NT-pro-BNP) are known biomarkers of heart failure in adult patients from many causes with probable relevance in children. Perhaps, pro-BNP or related molecules such as NT-pro-BNP are useful in the management of PSVT in infants, thus hastening treatment in children who may otherwise significantly decompensate. Case series of one infant and two neonates presenting with cardiogenic shock and evidence of heart failure are presented. Cardiac monitoring or electrocardiogram (ECG) confirmed the presence of PSVT. Adenosine was administered resulting in successful chemical cardioversion with each case. Significantly elevated NT-pro-BNP levels correlated with heart failure prior to cardioversion. In each case, patients were discharged home with lower NT-pro-BNP levels and maintenance with a β-blocker. Due to documented relationships between elevated pro-BNP level and heart failure in adults, the authors measured the related biomarker NT-pro-BNP in each case, as the relationship could be similar in pediatric PSVT. Based on our experience with children in acute heart failure from other causes, NT-pro-BNP can increase to potentially extreme levels in infants. It appears to correlate with clinical signs of insufficient cardiac output, such as tachycardia, respiratory distress, and moribund appearance. Indeed, in the case series, extremely high NT-pro-BNP values were obtained when the patients appeared moribund from decompensated PSVT. The question arising from these observations is: At what level of elevated NT-pro-BNP, would patients be identified for cardioversion prior to appearance of other signs and symptoms? For each patient within the case series, NT-pro-BNP levels of approximately 20,000 pg/mL were indicative of decompensated heart failure, which was subsequently confirmed by examination of the patient. Further investigation is needed to determine the clinical significance of NT-pro-BNP and related peptides in pediatric patients with PSVT and intermittent PSVT. However, the possibility exists that an increase in NT-pro-BNP and related peptides could be a biomarker for cardiac decompensation after prolonged or intermittent PSVT, thereby shortening the time of diagnosis and intervention, and hence, potentially preventing morbidity, mortality, and extended hospitalization. Additional evidence-based research would help provide biomarker information during PSVT allowing practitioners to more objectively analyze risks.

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