title: Bromocriptine treatment associated with recovery from peripartum cardiomyopathy in siblings: two case reports.
abstract: BACKGROUND
  Peripartum cardiomyopathy is a rare form of cardiomyopathy, with heterogeneous presentation occurring in women between one-month antepartum and six months postpartum. It carries a poor prognosis and a high risk of mortality.
  
  
  METHODS
  We report the development of peripartum cardiomyopathy in two sisters, 27- and 35-year-old African women, one of whom presented with a large left ventricular thrombus. Subsequently, both patients were treated with bromocriptine, heparin and standard therapy for heart failure (angiotensin converting enzyme inhibitors, beta-blockers and diuretics). During follow-up, the left ventricular thrombus observed in one patient degraded. Neither patient experienced a thrombotic event, and both experienced continuous improvements in cardiac function and New York Heart Association stage.
  
  
  CONCLUSIONS
  The development of peripartum cardiomyopathy in two sisters indicates that there may be a genetic basis for this type of cardiomyopathy, and that women with a positive family history for peripartum cardiomyopathy may have an increased risk of developing the disease. This is also the first report of a patient experiencing degradation of a large left ventricular thrombus under standard therapy for heart failure with bromocriptine. It suggests that the use of bromocriptine in association with adequate anti-coagulation and heart failure therapy may be beneficial and safe.
authors.affiliation: Department of Cardiology and Angiology, MHH, Carl Neuberg Strasse 1, 30625 Hannover, Germany. meyer.gerdp@mh-hannover.de.
authors.forename: Gerd Peter
authors.initials: GP
authors.lastname: Meyer
authors.forename: Saida
authors.initials: S
authors.lastname: Labidi
authors.forename: Edith
authors.initials: E
authors.lastname: Podewski
authors.forename: Karen
authors.initials: K
authors.lastname: Sliwa
authors.forename: Helmut
authors.initials: H
authors.lastname: Drexler
authors.forename: Denise
authors.initials: D
authors.lastname: Hilfiker-Kleiner