Presentation
Underlying hypertension. 5 months postpartum presented with chest pain, cough, dyspnea, orthopnea, headaches, and nausea.
Patient Data
The heart is enlarged. Normal pulmonary vasculature. Costophrenic angles are clear. No pulmonary lesion noted.
Dilated left ventricle (6 cm) with severely impaired systolic function. Left ventricular ejection fraction (LVEF) of 18%.
Moderate mitral regurgitation. Mild tricuspid regurgitation (not shown) with a tricuspid regurgitation peak gradient (TRPG) of 33 mmHg.
Bi-atrial dilatation. Normal right ventricular size with normal systolic function. Trace pericardial effusion. No thrombus seen.
Tricuspid annular plane systolic excursion (TAPSE): 1.8cm.
Right ventricular systolic velocity: 10 cm/s.
Case Discussion
Postpartum cardiomyopathy is a type of dilated cardiomyopathy that occurs within the first 6 months after delivery (postpartum). The mechanism that leads to postpartum cardiomyopathy remains ill-defined. It is a diagnosis of exclusion that is typically considered in younger patients with no history of cardiac disease or causes of heart failure 1.
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