ARCIMS 26
in
Sunday 2025-10-19 17:50
A 40-year-old woman with postpartum cardiomyopathy
Mohammad Akbar Afshar 1 ℗, Taherh Sadeghi 2 ©, Maryam Jamali 3, Marjan Hadadi 3, Sara Sedighi 3
Abstract
Introduction: Postpartum cardiomyopathy, also known as peripartum cardiomyopathy (PPCM), is heart failure that occurs between the last month of pregnancy and 5 months after delivery with no clear cause. It is a rare condition that varies in occurrence and prognosis based on race and geographic location. Postpartum cardiomyopathy can range from complete recovery to death, and it is diagnosed by ruling out other possible causes. This case report discusses the assessment, causes, and management of postpartum cardiomyopathy, and emphasizes the importance of a coordinated healthcare team in evaluating and treating patients with this condition.A 40-year-old female patient with cardiomyopathy after a controlled delivery was admitted to this center with abdominal pain, cystitis, multi-organ failure, and sepsis. An ICD was implanted for her. Case Presentation: A 40-year-old female patient with a history of postpartum cardiomyopathy, diagnosed about a month after her fourth delivery and under control, presented with abdominal pain. She was diagnosed with cystitis due to stones in the abdominal ultrasound. The patient was then referred to this hospital due to abnormal tests indicating pancreatitis and abnormal LFT. During hospitalization, the patient developed sepsis and multi-organ failure, including kidney and liver issues, and underwent supportive treatment, including DHF, antibiotic therapy, dialysis, and FFP injection. Additionally, a CLOT was identified in the TDI echo, which was treated with anticoagulants. In the follow-up echo, the clot was resolved after about a month of treatment. Eventually, the patient received an ICD due to EF drop and frequent arrhythmias. Discussion and Conclusion: In patients with heart failure and EF drop, early treatment of non-cardiac diseases is essential. Any factor that causes hemodynamic disturbance can exacerbate and decompensate heart failure, leading to multi-organ failure. Therefore, if the patient's cystitis had been treated early, the progression to organ failure could have been avoided.
Keywords: woman, postpartum ,cardiomyopathy
