Peripartum Cardiomyopathy: A Case Report of Mortality From a Rare and Potentially Fatal Condition

Abstract

Peripartum cardiomyopathy (PPCM) poses a significant challenge in maternal health, characterized by heart failure with reduced ejection fraction during late pregnancy or early postpartum. Despite advances in understanding PPCM, it remains life-threatening with substantial maternal morbidity and mortality. This article reviews the epidemiology, etiology, diagnostic challenges, management strategies, and outcomes associated with PPCM. A case report of a 29-year-old woman with PPCM is presented, emphasizing the importance of early recognition and tailored management. The patient's presentation was marked by atypical symptoms, including dysuria, lumbar pain, persistent fever, and oral intake intolerance. Despite aggressive medical intervention, the patient experienced a tragic outcome, succumbing to cardiopulmonary arrest within 48 h of admission. This case underscores the challenges in diagnosing and managing PPCM, particularly when presenting with nonspecific symptoms and emphasizes the urgent need for improved diagnostic criteria and therapeutic interventions to mitigate adverse outcomes in affected individuals.

Keywords: Heart failure; Maternal health; Mortality; Peripartum cardiomyopathy; Pregnancy.

Figure 1

Chest X-ray. Figure shows enlarged cardiac silhouette, bilateral pulmonary vascular congestion and diffuse interstitial edema consistent with pulmonary congestion (source: patient’s medical chart, 2023).

Figure 2

Transthoracic echocardiogram. Transthoracic echocardiogram shows left ventricular ejection fraction of 23%, right ventricle with moderately depressed systolic function, mild pericardial effusion and indirect signs with intermediate probability of pulmonary hypertension (Source: patient’s medical chart, 2023).

Figure 3

Case timeline. Figure summarizes the case presentation of the patient, exam findings, symptoms, treatments and progression to cardiorespiratory arrest (source: made by authors, 2024). ICU: intensive care unit; IV: intravenous; LVEF: left ventricular ejection fraction; PO₂: partial pressure of oxygen; PCO₂: partial pressure of carbon dioxide; HCO₃: bicarbonate; BE: base excess.