A case of peripartum cardiomyopathy with acute pulmonary edema after Cesarean delivery due to pregnancy-induced hypertension

Abstract

Peripartum cardiomyopathy (PPCM) shows a sudden onset in the last month of pregnancy or in the months following delivery in women without a history of cardiovascular disease. It is a potentially fatal condition. A 40-year-old primigravida underwent Cesarean delivery because of pregnancy-induced hypertension and had an uncomplicated postoperative course. On the postoperative day 8, she was intubated for sudden dyspnea and oxygen desaturation (SpO₂ 60% under room air). Chest radiography showed bilateral infiltrative shadows. Echocardiography revealed an estimated ejection fraction of 25%. Acute pulmonary edema because of PPCM was diagnosed. The left ventricular systolic function improved after infusion of carperitide and dobutamine. On the 3rd day of ICU admission, she was extubated. On the 4th day, she was discharged from the ICU. Earlier diagnosis of PPCM is difficult because symptoms such as shortness of breath appear in healthy pregnant women. Our patient had a good outcome because she received prompt intensive care.