C72. Peripartum Cardiomyopathy: “Comparison in Management of Two Cases”

Peripartum cardiomyopathy (PPCM) is a pregnancy related cardiomyopathy that associated with high morbidity, mortality, also high probability of partial and often full recovery. The management of PPCM remains challenging.

The first patient was 33 years old woman, diagnosed with PPCM 3 days after giving birth. The second patient was 30 years old woman with heart failure symptoms since 3 months after giving birth but only seek medical attention 10 months later. Both patients presented with heart failure and LVEF 37%. The difference was acute onset PPCM on the first patient and the second one was already fall to chronic heart failure condition due to untreated PPCM. Both patients were treated with heart failure drugs but no bromocriptine in second patient. Six months follow up showed increased LVEF to 65% in first patient with full recovery but no significant improvement on second patient with LVEF 40 %.

The first patient was presented as acute PPCM. Diagnosis PPCM in the second patient was made after exclusion of other causes of heart failure. Both women presenting after delivery, so can generally be treated according to the ESC Guidelines for heart failure. BOARD scheme therapy (Bromocriptine, Oral heart failure therapies, Anticoagulants, vasoRelaxing agents, Diuretic) were used in first patient but we treated the second patient as common heart failure patient without including bromocriptine in therapy. Full recovery found in patient that was diagnosed and treated earlier. Long term management and counselling is essential for these patients.