title: Myocardial infarction and ischemic hepatitis complicated by postpartum hemorrhage.
abstract: OBJECTIVE
  To present a rare case of life-threatening postpartum hemorrhage due to uterine atony complicated by acute myocardial infarction and ischemic hepatitis.
  
  
  METHODS
  A 37-year-old parturient, gravida 1 para 0, presented with symptoms and signs of shock due to postpartum hemorrhage after delivery. Ischemic hepatitis, pulmonary edema, and adult respiratory distress syndrome developed the following morning. On the 7(th) postpartum day, she developed chest pain and was subsequently diagnosed with acute inferior myocardial infarction based on serial changes on the electrocardiogram (ECG) and myocardial enzymes. The clinical condition improved after a series of resuscitative efforts and percutaneous transluminal coronary angioplasty.
  
  
  CONCLUSIONS
  The presented case demonstrated that when hypovolemic shock develops with complications of pulmonary edema or ischemic hepatitis, the possibility of cardiovascular disease should be immediately investigated and preventive measures initiated.
authors.affiliation: Department of General Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Meng-Han
authors.initials: MH
authors.lastname: Chou
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Ying-Chieh
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Kwei-Shuai
authors.initials: KS
authors.lastname: Hwang
authors.affiliation: Department of Obstetrics and Gynecology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan.
authors.forename: Mu-Hsien
authors.initials: MH
authors.lastname: Yu
authors.affiliation: Department of Obstetrics and Gynecology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan. Electronic address: su108868@gmail.com.
authors.forename: Her-Young
authors.initials: HY
authors.lastname: Su
mesh_terms: D000328:Adult; D005260:Female; D006505:Hepatitis / Q000209:etiology*; D006801:Humans; D007511:Ischemia / Q000209:etiology*; D008099:Liver / Q000098:blood supply*; D009203:Myocardial Infarction / Q000209:etiology*; D006473:Postpartum Hemorrhage / Q000209:etiology*; D011247:Pregnancy; D014593:Uterine Inertia
keywords: coronary artery disease; embolization; ischemic hepatitis; myocardial infarction; postpartum hemorrhage