title: A Case of Breathlessness during Pregnancy: The Difficulty in Diagnosing Heart Failure.
abstract: We present the case of a 33-year-old woman in her second pregnancy who was transferred to our unit following a one-month history of worsening fatigue and a three-day history of worsening symptoms of heart failure. Shortly after presentation she developed ventricular fibrillation and arrested. At an emergency caesarean section a placental abruption was noted and the baby was stillborn, unable to be resuscitated. The patient required a prolonged intensive and coronary care stay. Echocardiographic findings were consistent with dilated cardiomyopathy and as all investigations to ascertain a cause were negative she was diagnosed with peripartum cardiomyopathy. Her case highlights a potential fatal cause of breathlessness during pregnancy and the role of B-type natriuretic peptide to assist in the differential diagnosis of these cases.
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Timothy A C
authors.initials: TA
authors.lastname: Snow
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Cara A
authors.initials: CA
authors.lastname: Wasywich
authors.affiliation: Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand; National Women's Hospital and Green Lane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Stewart
keywords: cardiac; cardiology; cardiovascular; high-risk pregnancy; intensive care medicine