A case of severe peripartum cardiomyopathy requiring left ventricular assist device implantation despite the absence of late gadolinium enhancement on cardiovascular magnetic resonance imaging

Publication date: Available online 27 September 2019Source: Journal of Cardiology CasesAuthor(s): Chihiro Takuwa-Shiomi, Masataka Ogiso, Toshiaki Isogai, Ken Kato, Hiroyuki Tanaka, Takahiro Kiriu, Ai Masukawa, Hiroshi Niinami, Nobuhisa HagiwaraAbstractPeripartum cardiomyopathy (PPCM) is a rare disorder in which left ventricular (LV) systolic dysfunction and symptoms of heart failure (HF) occur in the peripartum period. The time to potential recovery from severe remodeling of ventricular function is difficult to predict. Although lack of late gadolinium enhancement (LGE) in cardiovascular magnetic resonance (CMR) is reportedly associated with functional recovery of the LV in some cardiomyopathies, the impact of LGE in PPCM remains unclear. We herein report a case of a patient with PPCM who demonstrated rapidly worsened ventricular function, leading to requirement of a paracorporeal left ventricular assist device (LVAD) implantation despite absence of LGE in CMR.A 34-year-old Japanese patient, G2P2A0, expecting her third delivery following a full-term pregnancy, experienced heart failure. Severe LV dysfunction and PPCM were diagnosed. CMR showed no LGE. Although standard HF therapy and bromocriptine were given, her cardiac function failed to recover, and she eventually underwent paracorporeal LVAD implantation as a bridge to heart transplantation due to the impossibility of stopping the administration of inotropic agents.
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research

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ConclusionsWe report the first data about procreation procedures in France, and wishes of patients, in non-syndromic hereditary heart diseases. This may help to better manage these complex issues in clinical practice.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
German cancer registry (Robert-Koch-Institute) data has shown a 16 fold risk of cancer in those with peripartum cardiomyopathy [1]. According to the report 21 of 236 patients had cancer, of which 12 had cancer diagnosed before peripartum cardiomyopathy. 11 of them had cardiotoxic chemotherapy. Of these, 17% fully recovered cardiac function compared to 55% of peripartum cardiomyopathy patients without cancer. Of the 10 patients who developed cancer after peripartum cardiomyopathy, 80% had left ventricular ejection fraction of 50% or more after cancer therapy. Authors mention that the high prevalence could be due to geneti...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardio Oncology Source Type: blogs
Ninefold higher cancer occurrence seen both before and after peripartum cardiomyopathy diagnosis
Source: The Doctors Lounge - Oncology - Category: Cancer & Oncology Tags: Cardiology, Family Medicine, Gynecology, Oncology, Pathology, Journal, Source Type: news
WEDNESDAY, Dec. 18, 2019 -- Patients with peripartum cardiomyopathy (PPCM) are more likely to have cancer before PPCM diagnosis and more likely to develop cancer after PPCM, according to a study published in the December issue of the JACC:...
Source: Drugs.com - Pharma News - Category: Pharmaceuticals Source Type: news
Heart failure is an uncommon diagnosis among pregnant women with limited data on this condition. We sought to describe the characteristics and outcomes of pregnant women with heart failure stratified by etiologies of cardiomyopathy.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
AbstractPurpose of reviewWhile the prognosis of peripartum cardiomyopathy (PPCM) is generally more favorable than other cardiomyopathies, PPCM can be associated with cardiogenic shock and significant maternal morbidity in young women. The management of a pregnant woman in cardiogenic shock necessitates consideration of harm to the fetus. This review focuses on the management of these women.Recent findingsA number of advances have increased the repertoire of therapies available to manage PPCM. Increased understanding of PPCM pathophysiology has led to a number of new and experimental medications. In the current era, mechani...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
Less is known about pregnancy in women with arrhythmogenic right ventricular cardiomyopathy (ARVC). From April 1995 to May 2018, 157 women with ARVC were retrospectively enrolled. Data on pregnancy and cardiac outcomes were analyzed. There were 224 pregnancies in 120 patients including 30 (13.4%) spontaneous and 2 (0.9%) medical abortions, 12 cardiac adverse events were recorded including new onset frequent premature ventricular contractions (PVC) in 3 (2.5%) patients, previous PVC numbers increased more than 100% in 5 (4.2%), syncope in 2 (1.7%), sustained ventricular tachycardia and heart failure required hospitalization...
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
(University of Pennsylvania School of Medicine) Women who are diagnosed with peripartum cardiomyopathy (PPCM) during late pregnancy or within a month following delivery are more likely to experience restored cardiac function and improved outcomes compared to those who are diagnosed later in the postpartum period, according to a new study. The findings underscore the need for increased awareness and monitoring of heart failure symptoms, particularly among black women, who, on average, are diagnosed significantly later than white patients, researchers found.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
ConclusionOur PPCM collective treated with standard therapy for heart failure, dopamine D2 receptor agonists, and anticoagulation displays a high and stable long ‐term recovery rate with low mortality at 5‐year follow‐up. However, long‐term use of cardiovascular medication, persisting orde novo hypertension and arrhythmias were frequent.
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Research Article Source Type: research
LV dysfunction is one of the most commonly used terminology by cardiac professionals.It can be systolic, diastolic or global, regional etc. But, before dysfunction sets in, the heart fights. The Left ventricle can behave in many different ways when confronted with stress. It increases the force of contraction, elevates it’s Intra cavitary filling pressure and still accomplishes its task of pumping adequately. Further, It can build fresh muscle (LVH). It can double up with more heartbeats. (All these factors are referred to as cardiac reserve mechanisms) These reserve mechanisms can be activated in the short or l...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: cardaic physiology cardiac physiology LV dilatation is diastolic dysfunction cardiac reserve cardiology research papers cardiology thesis topics dilated left ventricle lv dilatation is lv dysfunction Source Type: blogs
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