Bromocriptine treatment associated with recovery from peripartum cardiomyopathy in siblings: two case reports.
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.
Meyer
Gerd Peter
GP
Department of Cardiology and Angiology, MHH, Carl Neuberg Strasse 1, 30625 Hannover, Germany. meyer.gerdp@mh-hannover.de.
Labidi
Saida
S
Podewski
Edith
E
Sliwa
Karen
K
Drexler
Helmut
H
Hilfiker-Kleiner
Denise
D