UNASSIGNED: Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure associated with pregnancy without any other known cause. Most of the clinical presentation is similar to symptoms of advanced pregnancy making the diagnosis difficult. Reported are three patients who developed dyspnea, orthopnea, and dry cough during the first week of puerperium. On examination, bilateral lower limb edema and bilateral basal lung crepitation were present in all patients. Chest radiograph showed pulmonary edema in cases two and three, and pleural effusion in case one. All patients had reduced left ventricular ejection fraction and raised N-terminal pro-b-type natriuretic peptide (NT-proBNP) levels. Case two developed PPCM in the background of left pyelonephritis. Case three was complicated by acute kidney injury. All patients were managed with bromocriptine, diuretics, beta-blockers, ACE inhibitors, and fluid restriction. Hence, PPCM though rare should be considered as a differential in women presenting with features of heart failure in later months of pregnancy or within 5 months of delivery.
■围产期心肌病(PPCM)是与妊娠相关的心力衰竭的罕见原因,没有任何其他已知原因。大多数临床表现与晚期妊娠的症状相似,因此诊断困难。报告的是三名患者出现呼吸困难,端坐呼吸,产褥期第一周干咳.在检查中,所有患者均存在双侧下肢水肿和双侧基底肺起皱。胸片显示2例和3例肺水肿,病例一胸腔积液。所有患者的左心室射血分数均降低,N末端B型利钠肽原(NT-proBNP)水平升高。病例2在左肾盂肾炎背景下发展为PPCM。病例3并发急性肾损伤。所有患者均接受溴隐亭治疗,利尿剂,β受体阻滞剂,ACE抑制剂,和流体限制。因此,PPCM虽然罕见,但应该被认为是在妊娠后期或分娩后5个月内表现出心力衰竭特征的女性的差异。