Insuficiencia cardiaca congestiva en el embarazo, secundaria a miocardiopatía periparto. Reporte de caso.

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Bibliographic Details
Title:	Insuficiencia cardiaca congestiva en el embarazo, secundaria a miocardiopatía periparto. Reporte de caso.
Alternate Title:	Congestive heart failure in pregnancy secondary to peripartum cardiomyopathy. Case report.
Authors:	Morales-Martínez, Luis Carlos¹ luiscarlos.med@hotmail.com, Aguilar-Torres, César², Madrid-Dour, Eddy Alicia³, Hernández, Óscar Mario⁴, Mariñelarena-Carrillo, Edgar Omar⁵
Source:	Ginecología y Obstetricia de México. dic2022, Vol. 90 Issue 12, p1000-1009. 10p.
Subjects:	CONGESTIVE heart failure, HEART diseases in pregnancy, PERINATAL period, CARDIOMYOPATHIES, HEART valve diseases, DIFFERENTIAL diagnosis, MITRAL valve insufficiency, PREGNANCY complications
Abstract (English):	BACKGROUND: Peripartum heart disease occurs in 1 out of 4000 cases in the United States; currently, its exact origin is unknown, which is why they are called idiopathic. Genetic diseases, immunological problems and heart malformations have been associated, without being certain about the real origin of these pathologies. Peripartum cardiomyopathy is a rare pathology associated with pregnancy and the puerperium, the diagnosis criteria includes: a) Development of heart failure in the last month of pregnancy or in the 5 months after delivery, b) absence of identifiable causes of heart failure, c) absence of demonstrable heart disease prior to the last month of pregnancy and impaired left ventricular function (FEVI less than 45%). The presentation of the case will help to raise awareness about this problem. CLINICAL CASE: A 26-year-old female patient coursing second gestation in the 35.4 pregnancy week, who debuts abruptly with signs of congestive heart disease such as cough, edema, tachycardia and arterial hypertension. The pregnancy was solved by cesarean section with a subsequent stay in Intensive Care Unit, an unknown valvular disease was identified by echocardiography, as well as left ventricular failure and decreased FEVI. Finally, a definitive diagnosis of peripartum cardiomyopathy was integrated. CONCLUSIONS: Peripartum heart disease is a rare occurrence, with well-defined clinical pictures, but difficult to approach and diagnose. Where valvular heart disease is the last differential diagnosis for peripuerperal congestive heart disease, and few cases associated with peripartum cardiomyopathy have been described. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	INTRODUCCIÓN: En Estados Unidos, las cardiopatías periparto se registran en 1 de cada 4000 pacientes. Se consideran idiopáticas y se asocian con enfermedades genéticas, problemas inmunológicos y malformaciones cardiacas, sin que se tenga certeza del origen real de este tipo de enfermedades. La miocardiopatía periparto se asocia con el embarazo y el puerperio; los criterios diagnósticos incluyen: a) insuficiencia cardiaca en las últimas cuatro semanas del embarazo o en los cinco meses siguientes al parto, b) ausencia de causas identificables de insuficiencia cardiaca, c) ausencia de enfermedad cardiaca demostrable antes de las últimas cuatro semanas del embarazo y alteración de la función del ventrículo izquierdo (fracción de eyección del ventrículo izquierdo, menor del 45%). La presentación del caso ayudará a que se tenga conocimiento de este problema. CASO CLINICO: Paciente de 26 años, en curso de las 35.4 semanas de embarazo, con inicio abrupto de signos de cardiopatía congestiva: tos, edema, taquicardia e hipertensión arterial. El embarazo finalizó por cesárea, con traslado inmediato a la unidad de cuidados intensivos. La ecocardiografía reportó una valvulopatía no conocida, insuficiencia ventricular izquierda y disminución de la fracción de eyección del ventrículo izquierdo; con lo anterior se integró el diagnóstico de miocardiopatía periparto. CONCLUSIONES: Las cardiopatías periperiparto son alteraciones excepcionales, con cuadros clínicos debidamente definidos y diagnóstico complejo. Las valvulopatías son el último diagnóstico diferencial de cardiopatía congestiva peripuerperal y se han descrito pocos casos asociados con miocardiopatía periparto. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	BACKGROUND: Peripartum heart disease occurs in 1 out of 4000 cases in the United States; currently, its exact origin is unknown, which is why they are called idiopathic. Genetic diseases, immunological problems and heart malformations have been associated, without being certain about the real origin of these pathologies. Peripartum cardiomyopathy is a rare pathology associated with pregnancy and the puerperium, the diagnosis criteria includes: a) Development of heart failure in the last month of pregnancy or in the 5 months after delivery, b) absence of identifiable causes of heart failure, c) absence of demonstrable heart disease prior to the last month of pregnancy and impaired left ventricular function (FEVI less than 45%). The presentation of the case will help to raise awareness about this problem. CLINICAL CASE: A 26-year-old female patient coursing second gestation in the 35.4 pregnancy week, who debuts abruptly with signs of congestive heart disease such as cough, edema, tachycardia and arterial hypertension. The pregnancy was solved by cesarean section with a subsequent stay in Intensive Care Unit, an unknown valvular disease was identified by echocardiography, as well as left ventricular failure and decreased FEVI. Finally, a definitive diagnosis of peripartum cardiomyopathy was integrated. CONCLUSIONS: Peripartum heart disease is a rare occurrence, with well-defined clinical pictures, but difficult to approach and diagnose. Where valvular heart disease is the last differential diagnosis for peripuerperal congestive heart disease, and few cases associated with peripartum cardiomyopathy have been described. [ABSTRACT FROM AUTHOR]
ISSN:	03009041
DOI:	10.24245/gom.v90i12.5399