Suspicion of peripartum cardiomyopathy in a preeclamptic near term primigravid complicated with pulmonary edema and placental abruption: case report

Abstract

Although peripartum cardiomyopathy (PPCM) is known since 1800s its etiology is still unclear and its differential diagnosis and management is a challenge for the clinician. This task becomes even more complicated when preeclampsia comes into play because the current guidelines state that hypertensive crises and preeclampsia ought to rule out PPCM. Nevertheless, new scientific evidence points out a link between preeclampsia and PPCM. We present the case of a 31-year-old female patient admitted at 35 weeks of gestation who required an emergent cesarean section delivery due to acute pulmonary edema and preeclampsia. Following hospitalization, signs of possible peripartum cardiomyopathy were found – although such possibility was later ruled out because of ESC 2018 guidelines. This case should make us reflect on the possibility of underdiagnosis, and thus undertreatment of PPCM due to not-so-up-to-date guidelines.