Postpartum depression and apical ballooning syndrome (takotsubo syndrome).
BACKGROUND
Acute cardiac complications occur occasionally during pregnancy and in the immediate postpartum period. Some of these cardiac scenarios are rare and provide a diagnostic challenge. We report a case of apical ballooning syndrome (ABS), also known as takotsubo cardiomyopathy or broken-heart syndrome, in a postpartum patient.


METHODS
A 32-year-old multigravid woman presented at 17 days after delivery with chest pain typical for cardiac ischemic pain. Her prior obstetrical history included two uncomplicated vaginal deliveries, and the current postpartum period had been uncomplicated until the time of presentation. Cardiac catheterization was performed and showed normal coronary blood vessels with no evidence of coronary artery occlusion. Left ventricular systolic function was moderately depressed, with an ejection fraction of 45%. The patient had full recovery of myocardial function in less than 40 days, with a subsequent echocardiogram during that time showing a normal ejection fraction of 65%.


CONCLUSIONS
Apical ballooning syndrome is a rare reversible cardiac condition that should be differentiated from ischemic and peripartum cardiomyopathy, especially in the immediate postpartum period.
Yaqub
Yasir
Y
Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock TX.
Jenkins
Leigh Ann
LA
Division of Cardiology, Texas Tech University Health Science Center, Lubbock TX.
Nugent
Kenneth M
KM
Department of Internal Medicine, Texas Tech University Health Science Center, Lubbock TX.
Chokesuwattanaskul
Warangkana
W
Division of Cardiology, Texas Tech University Health Science Center, Lubbock TX.
D000328:Adult; D006328:Cardiac Catheterization; D019052:Depression, Postpartum / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D013318:Stroke Volume / Q000502:physiology; D054549:Takotsubo Cardiomyopathy / Q000503:physiopathology*