title: [Acute heart failure due to myocarditis in the first trimester of pregnancy].
abstract: The incidence of cardiovascular diseases in pregnancy is estimated at about 1%. Pregnant women suffer from rheumatic diseases of the heart valves, hypertension, congenital heart deffects, inflammatory and ischemic disorders or pathologies of the electrical conduction system of the heart. Myocarditis during pregnancy occurs very seldom. Few cases of severe myocarditis during gestation have been reported in the literature. This report presents a case of a 27-year-old Asian patient, at 8 weeks of gestation, diagnosed with an acute myocarditis. The woman was admitted to the hospital, presenting with early and nonspecific symptoms, (fever up of 38.5 degrees Celsiuss, abdominal pain and nausea). After temporary improvement, the patient's condition deteriorated. On the fourth day of the hospitalization, myocarditis led to heart failure and the patient had to be transffered to the Intensive Care Unit. Wide-spectrum antibiotics, glucocorticoids, diuretics, bisoprolol, as well as fluid and electrolyte supplementation, were administered. After 22 days of treatment the patient was discharged home in good condition. Afterwards she attended follow-up visits at the Gynecology-Obstetric Outpatient Clinic. She delivered a healthy son (2340 grams, 51 centimetres, Apgar 10) at 37 weeks of gestation. At present, she remains under the care of the Cardiac Clinic and requires small doses of bisoprolol because of periodic supraventricular arrhythmias.
authors.affiliation: ' I Klinika Połoznictwa i Ginekologii, Warszawski Uniwersytet Medyczny, Warszawa, Polska.
authors.forename: Michał
authors.initials: M
authors.lastname: Głuszak
authors.forename: Elibieta
authors.initials: E
authors.lastname: Borowiecka
authors.forename: Anna
authors.initials: A
authors.lastname: Borowiecka-Elwertowska
authors.forename: Ewa
authors.initials: E
authors.lastname: Barcz
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D009205:Myocarditis / Q000150:complications* / Q000188:drug therapy*; D011181:Postnatal Care; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000188:drug therapy*; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First; D016896:Treatment Outcome