Abstract
A 28-year old woman was admitted to a maternity unit because of preterm labour at 22 week of gestation. She had no cardiac risk factors. The β2-agonist ritodrine (15mg·day-1) was orally administered since 15 week of gestation, and was switched to continuous and intravascular administration at 67-200μg·min-1 after admission. At 38 week of gestation, Caesarean operation was carried out. After delivering a healthy baby with an Apgar score of 9, she suddenly complained of dyspnea and was transferred to an intensive care unit. She was diagnosed as pulmonary edema due to acute heart failure. Echocardiogram demonstrated evident hypokinesis. Both [201T1]-thallium chloride and [123I]-metaiodobenzylguanidine scintigram on the 9th day showed poor uptake. The serum creatine phosphokinase (CPK) level remained normal. She was given oxygen and a diuretic, which rapidly improved pulmonary edema. She spent 4 days in the intensive care unit and discharged on the 19th day thereafter. Chronic administration of the β2 agonist for prevention of premature labour might be associated with acute pulmonary edema and so-called “takotsubo” myopathy (ampulla-like left ventricular dysfunction).
