背景:在高血压背景下发生的围产期心肌病(PPCM)提出了独特的临床挑战。这个案例有助于医学文献通过强调治疗心力衰竭的复杂性在产后妇女预先存在的高血压疾病,特别是当患有先兆子痫的病史时。
方法:O.O.女士,一个34岁的高血压女性,出现进行性呼吸困难,双侧腿部肿胀,和端坐呼吸。值得注意的是,她有先兆子痫病史,并在几个月内表现出恶化的症状.
方法:患者被诊断为PPCM继发的失代偿性心力衰竭,高血压和贫血加剧。
方法:治疗性干预措施包括利尿剂,血管紧张素受体-脑啡肽抑制剂,地高辛,和抗凝。此外,实施了生活方式改变和饮食限制.
结果:调整治疗后,患者症状明显改善,运动耐受力,和心脏功能。从NYHAIII级到II级心力衰竭的过渡表明成功的管理。
结论:该案例强调了在高血压患者中管理PPCM的综合方法的重要性,关注心血管和产科因素。它强调了多学科护理在取得积极成果方面的有效性,并强调有心血管危险因素的产后妇女需要提高警惕。
BACKGROUND: Peripartum cardiomyopathy (PPCM) occurring in the context of hypertension presents a unique clinical challenge. This
case contributes to the medical literature by highlighting the complexities of managing heart failure in postpartum women with pre-existing hypertensive disorders, particularly when complicated by a history of preeclampsia.
METHODS: Mrs. O.O., a 34-year-old hypertensive woman, presented with progressive dyspnea, bilateral leg swelling, and orthopnea. Notably, she had a history of previous preeclampsia and exhibited worsening symptoms over several months.
METHODS: The patient was diagnosed with decompensated heart failure secondary to PPCM, exacerbated by hypertension and anemia.
METHODS: Therapeutic interventions included diuretics, angiotensin receptor-neprilysin inhibitors, digoxin, and anticoagulation. Additionally, lifestyle modifications and dietary restrictions were implemented.
RESULTS: Following treatment adjustments, the patient demonstrated significant improvement in symptoms, exercise tolerance, and cardiac function. The transition from NYHA class III to class II heart failure indicated successful management.
CONCLUSIONS: This
case underscores the importance of a comprehensive approach to managing PPCM in hypertensive patients, with attention to cardiovascular and obstetric factors. It highlights the effectiveness of multidisciplinary care in achieving positive outcomes and emphasizes the need for heightened vigilance in postpartum women with cardiovascular risk factors.