Abstract:
Peripartum cardiomyopathy (PPCM) is a rare disorder in which left ventricular systolic dysfunction and heart failure symptoms occur during the peripartum period. Inhibition of prolactin secretion by bromocriptine mediates beneficial effects on cardiac function in PPCM. Mental disorders are also associated with the onset of PPCM. Psychiatric medications for mental disorders would affect serotonin production and tryptophan and dopamine metabolism, and they are associated with PPCM. Conversely, bromocriptine affects psychiatric symptoms; therefore, the treatment of PPCM complicated by mental disorders using bromocriptine may be difficult. Herein, we report cases of two patients with PPCM and mental disorders successfully treated with bromocriptine therapy. The first case involved a 33-year-old woman with a history of atypical depression and anxiety disorder, who developed PPCM with a left ventricular ejection fraction (LVEF) of 19 %. The second case was that of a 42-year-old woman with a history of bipolar and panic disorders who developed PPCM with an LVEF of 18 %. Both patients were administered bromocriptine; however, psychiatric symptoms did not worsen and cardiac function improved. We also review the literature on the relationship between PPCM and mental disorders.
UNASSIGNED: Mental disorders and psychiatric medications may be associated with the onset of peripartum cardiomyopathy (PPCM). Although bromocriptine has beneficial effects on PPCM, it has also been reported to increase the risk of worsening psychiatric symptoms; therefore, the efficacy and safety of bromocriptine in PPCM patients with mental disorders is controversial. Our cases showed that bromocriptine can be used safely without worsening psychiatric symptoms in PPCM with mental disorders.
摘要:
围产期心肌病(PPCM)是一种罕见的疾病,在围产期发生左心室收缩功能障碍和心力衰竭症状。溴隐亭抑制催乳素分泌介导对PPCM心脏功能的有益作用。精神障碍也与PPCM的发作有关。治疗精神障碍的精神药物会影响血清素的产生以及色氨酸和多巴胺的代谢,它们与PPCM有关。相反,溴隐亭影响精神症状;因此,使用溴隐亭治疗PPCM并发精神障碍可能很困难.在这里,我们报道了2例PPCM和精神障碍患者成功接受溴隐亭治疗的病例.首例病例涉及一名33岁女性,有非典型抑郁症及焦虑症病史,发展为PPCM的左心室射血分数(LVEF)为19%。第二例是一名42岁的女性,有躁郁症和惊恐障碍病史,患有PPCM,LVEF为18%。两名患者均服用溴隐亭;然而,精神症状没有恶化,心功能改善.我们还回顾了有关PPCM与精神障碍之间关系的文献。
精神障碍和精神科药物可能与围产期心肌病(PPCM)的发病有关。虽然溴隐亭对PPCM有有益作用,据报道,它也增加了精神症状恶化的风险;因此,溴隐亭治疗PPCM伴精神障碍患者的疗效和安全性存在争议.我们的病例表明,在患有精神障碍的PPCM中,溴隐亭可以安全地使用,而不会恶化精神症状。