title: Reverse Apical Ballooning Echocardiographic Pattern in Eclampsia-Related Cardiomyopathy.
abstract: The diagnosis of heart failure during pregnancy has important management implications for the parturient and her fetus. A 19-year-old primigravida developed eclampsia at 29 weeks' gestation. Echocardiography demonstrated normal left ventricular size and ejection fraction of 35% with reverse apical ballooning (reverse takotsubo pattern). Under general anesthesia with invasive monitoring, she underwent urgent cesarean delivery of a preterm infant. Follow-up echocardiography 4 weeks after delivery showed complete normalization of her ejection fraction (56%). This case of eclampsia-related stress-induced cardiomyopathy is a distinct entity from peripartum cardiomyopathy. Using echocardiography, the diagnoses should be differentiated with appropriate management and counseling.
authors.affiliation: From the *Department of Anesthesiology, Mayo Clinic Rochester, Rochester, Minnesota; †Department of Obstetrics and Gynecology, Mayo Clinic Rochester, Rochester, Minnesota; and ‡Department of Cardiovascular Diseases, Mayo Clinic Rochester, Rochester, Minnesota.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gleich
authors.forename: David W
authors.initials: DW
authors.lastname: Barbara
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Arendt
authors.forename: Carl H
authors.initials: CH
authors.lastname: Rose
authors.forename: Lori A
authors.initials: LA
authors.lastname: Blauwet
mesh_terms: D000768:Anesthesia, General; D000927:Anticonvulsants / Q000627:therapeutic use; D002585:Cesarean Section; D003937:Diagnosis, Differential; D004452:Echocardiography; D004461:Eclampsia / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007234:Infant, Premature; D007362:Intensive Care Units; D008278:Magnesium Sulfate / Q000627:therapeutic use; D011247:Pregnancy; D012640:Seizures / Q000628:therapy; D013318:Stroke Volume; D054549:Takotsubo Cardiomyopathy / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D008278:Magnesium Sulfate