Peripartum cardiomyopathy or takotsubo cardiomyopathy? The clinical case with arterial hypotension and pulmonary edema
https://doi.org/10.18087/cardio.2020.7.n742
Abstract
A 29-year old female patient without a history of cardiovascular diseases was admitted on emergency to a surgical hospital with acute calculous cholecystitis in 3 months after uncomplicated term birth. During laparoscopic cholecystectomy, she developed arterial hypotension with pulmonary edema, which required intravenous sympathomimetics. On the next day, after improvement of the condition and stabilization of hemodynamics, cardiac ultrasound showed diffuse left ventricular (LV) hypokinesis with the ejection fraction (EF) of 38 %. Electrocardiogram detected transient left bundle branch block followed by persistent negative T waves in leads I, aVL, and V2 V6. Troponin I concentration was increased to 1.2 ng /ml. Beta-blocker and angiotensin-converting enzyme inhibitor were administered. At 10 days, the LV contractile function completely recovered with LV EF of 59 %. Magnetic resonance imaging did not reveal any signs of myocardial infarction or myocarditis. A differential diagnosis was performed between peripartum cardiomyopathy and Takotsubo syndrome. Considering the fast recovery of LV systolic function, the patient was discharged with a diagnosis of Takotsubo syndrome.
Supporting agencies: No conflict of interest is reported.
About the Authors
E. V. Vyshlov
Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences, Russia
Russian Federation
Russian Federation
1. Leading researcher of Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
2. Docent of cardiology department of Siberian State Medical University,Tomsk, Russia
3. Professor of N.F. Katanov Khakassian State University. Abakan, Russia
E. I. Tsoi
Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences, Russia
Russian Federation
Junior researcher of Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation
Junior researcher of Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
S. V. Demyanov
Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences, Russia
Russian Federation
Researcher of Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation
Researcher of Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
V. V. Ryabov
Research Institute of Cardiology, Tomsk National Research Medical Center of the Russian Academy of Sciences, Russia
Russian Federation
Russian Federation
1. Head of Department of Emergency Cardiology of Cardiology Research Institute, Tomsk National Research Medical Centre, Russian Academy of Sciences
2. Head of cardiology department of Siberian State Medical University,Tomsk, Russia
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Review
For citations:
Vyshlov E.V., Tsoi E.I., Demyanov S.V., Ryabov V.V. Peripartum cardiomyopathy or takotsubo cardiomyopathy? The clinical case with arterial hypotension and pulmonary edema. Kardiologiia. 2020;60(7):136-140. (In Russ.) https://doi.org/10.18087/cardio.2020.7.n742
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