[Suspected case of peripartum cardiomyopathy developed during elective cesarean section].
A 35-year-old primigravida with twin gestation was admitted for elective cesarean section. She had no preoperative systemic diseases including heart disease. At 37 weeks of gestation, elective cesarean section was performed under combined spinal-epidural anesthesia. Anesthetic course was uneventful until the delivery when the patient started to cough and complained of dyspnea. At the same time, Spo2 started to decline to reach 95% despite the oxygen supplement. Pleural effusion was observed on the chest X-ray on postoperative day 2. An echocardiography showed diffuse hypokinesis of the left ventricle with ejection fraction (EF) of 36%. Peripartum cardiomyopathy was strongly suspected. Symptoms of heart failure were alleviated by water restriction and furosemide by the 9th POD. The EF increased to 50% on the 15th POD.
Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8431.
Maiko
M
Hasegawa-Moriyama
Ayumi
A
Fujimoto
Kazuyoshi
K
Aoyama
Mina
M
Imai
Takehiko
T
Kikutani
Masayuki
M
Oshima
Seijiro
S
Sonoda
Eiichi
E
Inada
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000628:therapy*; D002585:Cesarean Section; D004232:Diuretics / Q000008:administration & dosage; D004452:Echocardiography; D017558:Elective Surgical Procedures; D005260:Female; D005665:Furosemide / Q000008:administration & dosage; D006333:Heart Failure / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis* / Q000628:therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome; D014867:Water / Q000008:administration & dosage
D004232:Diuretics; D014867:Water; D005665:Furosemide