Miocardiopatía periparto con trombosis biventricular

Lezcano, Juan Sánchez‐Rubio; Osuna, José Gabriel Galache; Barcos, Adolfo Marquina; Cebollero, Isabel Calvo; Miguel, José Antonio Diarte de; Peralta, Luis J. Placer

doi:10.4321/s0212-71992004001000008

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…A high incidence of thromboembolic events (Bennani 2003; Box 2004; Damorou 2000; Kaufman 2003; Nishi 2002; Quinn 2004; Sanchez-Rubio Lezcano 2004) and bedrest as an adjunct to medical and supportive therapy has also encouraged the widespread use of thromboprophylaxis in these patients, although this practice is based on expert opinion rather than any data from experimental studies (Abboud 2007).…”

Section: Introductionmentioning

confidence: 99%

Interventions for treating peripartum cardiomyopathy to improve outcomes for women and babies

Carlin

Alfirević

Gyte

2010

Cochrane Database of Systematic Reviews

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Background Peripartum cardiomyopathy (PPCM or PCMO) is a rare disease of unknown etiology, characterised by an acute onset of heart failure in women in the late stage of pregnancy or in the early months postpartum. Objectives To assess the effectiveness and safety of any intervention for the care of women and/or their babies with a diagnosis of peripartum cardiomyopathy. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (27 July 2010) and the reference lists of identified studies. Selection criteria Randomised and quasi-randomised controlled trials of any intervention for treating peripartum cardiomyopathy. Such interventions include: drugs; cardiac monitoring and treatment; haemodynamic monitoring and treatments; supportive therapies and heart transplant. Data collection and analysis Two authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Data entry was checked. Main results We identified and included one pilot study, involving 20 women, undertaken in South Africa. Women were diagnosed postnatally and included in the study within 24 hours of diagnosis. Authors’ conclusions There are insufficient data to draw any firm conclusions. Treatment with bromocriptine appears promising, although women would be unable to breastfeed due to suppression of lactation.

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Section: Introductionmentioning

confidence: 99%

Interventions for treating peripartum cardiomyopathy to improve outcomes for women and babies

Carlin

Alfirević

Gyte

2010

Cochrane Database of Systematic Reviews

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“…To date, only 11 cases have been reported (Table 1). In these reports, the age at presentation ranged between 19 and 39 years [1,12], only ve cases documented the parity at presentation which was between 2 and 7 [3,4,[13][14][15], and the onset of heart failure symptoms varied from 2 weeks to 5 months [3,16]. In the index case, our patient was in her early 40s, she was quite older compared to patients in previous cases, her gravidity was 6 and the manifestations of heart failure symptoms began 5 months post-delivery similar to existing cases.…”

Section: Discussionmentioning

confidence: 99%

“…In the index case, the ejection fraction was 28% similar to existing cases. Embolic events were common in reported cases, only 5 cases didn't show evidence of embolic phenomena [1,11,12,15,16] similar to the index case. Among the cases that demonstrated embolic events: pulmonary embolism was reported in 2 cases, cerebral embolism in 2 cases, and hepatic infarction in 2 cases.…”

Section: Discussionmentioning

confidence: 99%

“…As per the heart failure guidelines for peripartum cardiomyopathy, anticoagulation therapy should be continued until left ventricular function normalizes [2], that's within 2 to 6 months in 23 to 72% of cases, but it can take longer up to 5 years [20]. In previous cases of biventricular thrombi, 5 patients had clot resolution within 3 weeks [4,11,13,16], except a single patient who had clot resolution after 3 months [15], and other 5 cases lacked data on clot resolution [1,3,12,14,17,18]. Similarly, the time to clot resolution in our case was 2 weeks.…”

Section: Discussionmentioning

confidence: 99%

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Multiple biventricular intracardiac thrombi an unusual finding in peripartum cardiomyopathy: A case report

Edwin,

Mbishi,

Alphonce

et al. 2024

Preprint

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Introduction: Peripartum Cardiomyopathy (PPCM) is a rare form of heart failure occurring during late pregnancy or within five months postpartum, its etiology remaining elusive. While typically characterized by left ventricular dysfunction, it may present with intracardiac thrombi, raising the risk of systemic embolization. Here, we report an unusual case of PPCM featuring biventricular intracardiac thrombi, highlighting the importance of a thorough investigation for potential underlying causes. Case presentation: This is a case of a black African, multiparous woman aged 44 years with an unremarkable past medical history, who presented with symptoms suggestive of acute heart failure five months after her last delivery. A 2D Transthoracic Echocardiography showed multiple biventricular intracardiac thrombi, a rare complication of PPCM without a systemic embolic event. Further, laboratory tests for evidence of a hypercoagulable state came out negative. Treatment involved a combination of acute heart failure, and anticoagulation followed by optimal medical therapy for chronic heart failure, resulting in improved symptoms for heart failure, cardiac function, and significant thrombi resolution after 8 weeks. Conclusion Multiple biventricular intracardiac thrombi are uncommon finding in Peripartum Cardiomyopathy (PPCM), emphasizing the need for vigilant diagnosis and management. Despite the absence of identifiable secondary causes, prompt management of acute heart failure and anticoagulation led to significant thrombi resolution and improved cardiac function. This case highlighted the significance of the complex management of PPCM, in an individualized manner.

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“…Several studies have also demonstrated a high incidence of thromboembolism in patients with PPCM. A clinical or pathological suspicion of PPCM should, therefore, lead a pathologist to carefully examine the vasculature including the pulmonary arteries, coronary arteries, and cerebral and limb vessels (14,25–32). Conversely, the finding of pulmonary thromboembolism should raise the possibility of PPCM.…”

Section: Peripartum Cardiomyopathy (Ppcm)mentioning

confidence: 99%

Cardiovascular Conditions and the Evaluation of the Heart in Pregnancy‐Associated Autopsies

Herbst

Winskog

Byard

2010

Journal of Forensic Sciences

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Pregnancy-associated death is defined as the death of a woman from any cause during pregnancy or in the year after delivery. This review concentrates on cardiac conditions that may result in pregnancy-associated death including, but not limited to, acute myocardial infarction, endocarditis, peripartum cardiomyopathy, and prolonged QT syndrome. Lethal vascular conditions may also occur involving arterial dissection and thromboembolism, on occasion exacerbated by hypercoagulability, and altered hormonal and physiologic states. The autopsy evaluation of these patients includes a careful assessment of the medical history particularly for prior pregnancy-related conditions, fetal loss, and episodes of unexplained collapse. A family history of sudden death at an early age may be significant. At autopsy, evaluation for underlying syndromes such as Marfan, or evidence of intravenous narcotism should be undertaken. Autopsy examination involves careful dissection of the heart and vessels with consideration of conduction tract studies and possible genetic evaluation for prolonged QT syndrome.

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Miocardiopatía periparto con trombosis biventricular

Cited by 4 publications

References 7 publications

Interventions for treating peripartum cardiomyopathy to improve outcomes for women and babies

Interventions for treating peripartum cardiomyopathy to improve outcomes for women and babies

Multiple biventricular intracardiac thrombi an unusual finding in peripartum cardiomyopathy: A case report

Cardiovascular Conditions and the Evaluation of the Heart in Pregnancy‐Associated Autopsies

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