An unexpected battle with peripartum cardiomyopathy: a case report

Abstract

Peripartum cardiomyopathy (PPCM) is a rare cardiomyopathy marked by systolic dysfunction that presents in late pregnancy or the early postpartum period with an ejection fraction (EF) of less than 45%. Diagnosing PPCM often presents a diagnostic dilemma due to its nonspecific clinical presentation, which usually resembles physiological changes of pregnancy or peripartum pulmonary embolism. Echocardiography is frequently used as a diagnostic modality of choice with management following the GDMT guidelines and delivery. This case presents a 23-year-old patient with a delayed diagnosis of PPCM, followed by a discussion of goal-directed medical therapy (GDMT) and the benefits of early diagnosis and treatment. Common pitfalls in diagnosing PPCM are introduced to encourage clinicians to consider PPCM during late pregnancy. Currently, a new clinical trial is underway investigating the efficacy of dopamine agonists in conjunction with GDMT for treatment of peripartum cardiomyopathy.