Abstract
A twenty-nine-years-old woman without known heart disease became dyspneic three days after the full term of normal delivery. Six days after delivery, her condition deterio-rated to the extent that she became orthopneic and she was brought to Okayama National Hospital in emergency.
The echocardiography revealed a wide left ventricular chamber with a hypokinetic inter-ventricular septum and left ventricular posterior wall, and she was diagnosed as post-partum cardiomyopathy. Digitalis and diuretics were started without relief of dyspnea. Prazosin and nitroglycerin were added as a vasodilator, but the effect of the vasodilating drugs was temporary and she remained dyspneic. Then, the ultrafiltration method was adopted to dehydrate the patient, but the effect was so minimal that the patient died twenty-three days after the delivery.
The autopsy was performed. Both ventricular chambers were remarkably dilated and mural thrombus was found at the left ventricular apex. Histologically, the myocardium showed varying degrees of atrophy and degeneration of muscle fibers. In the pulmonary arteries, massive thrombus was found, which had made this disease refractory to the thera-py, and it was thought to have come from the pelvic or deep vein thrombus.
It was further discovered that the mother of this patient died of a heart disease forty days after the delivery of her second child, i. e. this patient. There are, also, several reports on record of the familial ocurrence of postpartum heart failure. The genetic factor, therefore, may be suspected in the case of this patient
