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EARLY ONSET PERIPARTUM CARDIOMYOPATHY FOLLOWING DILATION AND EVACUATION FOR COMPLETE HYDATIDIFORM MOLE COEXISTENT WITH LIVE FETUS
A629 JACC March 17, 2015 Volume 65, Issue 10S
FIT Clinical Decision Making Early Onset Peripartum Cardiomyopathy Following Dilation and Evacuation for Complete Hydatidiform Mole Coexistent with Live Fetus Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m. Session Title: FIT Clinical Decision Making: Heart Failure and Cardiomyopathies Abstract Category: Heart Failure and Cardiomyopathies Presentation Number: 1109-170 Authors: Yuichi Saito, Hiroyuki Takaoka, Nobusada Funabashi, Hiroshi Hasegawa, Akiko Omoto, Hirokazu Usui, Makio Shozu, Yoshio Kobayashi, Chiba University Graduate School of Medicine, Chiba, Japan
Background: Peripartum cardiomyopathy (PPCM) is a rare disorder (1 case per 1,000 to 4,000 live births). Complete hydatidiform mole and coexistent fetus (CMCF) is even less common (1 in 22,000 to 100,000 pregnancies).
Case: A 33 year old primigravida with no remarkable past medical history was admitted at 12 weeks gestation due to CMCF. One week later she developed hypertension with leg edema. At 15 weeks gestation, the chest X-ray (CXR) showed cardiac enlargement and her serum brain natriuretic peptide level was elevated to 1,480 pg/mL, but transthoracic echocardiography (TTE) revealed a preserved left ventricular ejection fraction (LVEF) of 59%. Since live birth was unlikely, pregnancy was terminated by dilation and evacuation.
Decision Making: She developed dyspnea 12 hours later. The CXR revealed increased cardiac enlargement with pulmonary vascular congestion, and TTE showed a reduced LVEF of 29%. There was no evidence of pulmonary thromboembolism. She responded well to diuretic treatment, and was discharged with improved left ventricular size and LVEF of 50%. Recent reports indicate that PPCM sometimes occurs early in pregnancy, but to our knowledge PPCM accompanied by CMCF has never been reported in early pregnancy. Conclusion: We report a case of PPCM accompanied by CMCF occurring in early pregnancy. In instances with initial CXR cardiomegaly, hypertension, and elevated brain natriuretic peptide levels but preserved LVEF on TTE, subsequent occurrence of full-blown PPCM should be anticipated.
FIT Clinical Decision Making Early Onset Peripartum Cardiomyopathy Following Dilation and Evacuation for Complete Hydatidiform Mole Coexistent with Live Fetus Poster Contributions Poster Hall B1 Saturday, March 14, 2015, 10:00 a.m.-10:45 a.m. Session Title: FIT Clinical Decision Making: Heart Failure and Cardiomyopathies Abstract Category: Heart Failure and Cardiomyopathies Presentation Number: 1109-170 Authors: Yuichi Saito, Hiroyuki Takaoka, Nobusada Funabashi, Hiroshi Hasegawa, Akiko Omoto, Hirokazu Usui, Makio Shozu, Yoshio Kobayashi, Chiba University Graduate School of Medicine, Chiba, Japan
Background: Peripartum cardiomyopathy (PPCM) is a rare disorder (1 case per 1,000 to 4,000 live births). Complete hydatidiform mole and coexistent fetus (CMCF) is even less common (1 in 22,000 to 100,000 pregnancies).
Case: A 33 year old primigravida with no remarkable past medical history was admitted at 12 weeks gestation due to CMCF. One week later she developed hypertension with leg edema. At 15 weeks gestation, the chest X-ray (CXR) showed cardiac enlargement and her serum brain natriuretic peptide level was elevated to 1,480 pg/mL, but transthoracic echocardiography (TTE) revealed a preserved left ventricular ejection fraction (LVEF) of 59%. Since live birth was unlikely, pregnancy was terminated by dilation and evacuation.
Decision Making: She developed dyspnea 12 hours later. The CXR revealed increased cardiac enlargement with pulmonary vascular congestion, and TTE showed a reduced LVEF of 29%. There was no evidence of pulmonary thromboembolism. She responded well to diuretic treatment, and was discharged with improved left ventricular size and LVEF of 50%. Recent reports indicate that PPCM sometimes occurs early in pregnancy, but to our knowledge PPCM accompanied by CMCF has never been reported in early pregnancy. Conclusion: We report a case of PPCM accompanied by CMCF occurring in early pregnancy. In instances with initial CXR cardiomegaly, hypertension, and elevated brain natriuretic peptide levels but preserved LVEF on TTE, subsequent occurrence of full-blown PPCM should be anticipated.