Successful treatment of severe myocardial failure after postpartum haemorrhage with the use of an intra-aortic balloon pump.
We report a 29-year-old primigravid who developed cardiac failure following postpartum haemorrhage unresponsive to volume resuscitation and therapy with catecholamines and phosphodiesterase-inhibitors. Transoesophageal echocardiography (TEE) demonstrated left atrial and ventricular dilatation and global left ventricular hypokinesis. No elevation of serum MB-isoenzyme fraction was detected and other organ functions remained stable. Although emergency cardiac transplantation was considered in the presented patient, the institution of intra-aortic counterpulsation was decided on as a first treatment option. Intra-aortic balloon counter-pulsation rapidly improved cardiac function and led to weaning from pharmacological cardiac support within a few days. Mechanical circulatory assist devices can be life-saving in postpartum-haemorrhage-associated cardiac failure.
Mayr
A
A
Department of Anaesthesia and Intensive Care Medicine, The Leopold-Franzens-University of Innsbruck, Austria.
Lederer
W
W
Mörtl
M
M
Margreiter
J
J
Hoi
M
M
Hasibeder
W
W
Mutz
N
N
D000328:Adult; D017548:Echocardiography, Transesophageal; D005260:Female; D006333:Heart Failure / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D006473:Postpartum Hemorrhage / Q000150:complications*; D011247:Pregnancy; D016896:Treatment Outcome