Concluded Case

Peripartum cardiomyopathy

young female delivered 6 days back. Complaining of breathlessness for last 4-5 days. It's her second delivery. Previous delivery was uneventful. Her CVS was normal. chest was full of crepts. Her chest X-ray was done . Subsequently echo was done . Her LVIDd was 57mm. LVEF was 30%. What is your diagnosis? How to manage her?

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Concluded answer

It's a case of Peripartum cardiomyopathy. It's cause is not well understood. Usually occurs in last trimester to first 6months of delivery. Risk factors include multipara, increasing age, malnutrition. Usually present with SOB. On CXR, you will find cardiomegaly. On echocardiography you will find EF less than 45% Dialated LV All valves normal Treat with diuretics, ACEI or ARB only after delivery. BB once patient is stablizes,not in acute failure. Selenium/zinc Antioxidant Bromocriptin is under investigation

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Bil Hyperinflated Lungs Cardiomegaly Straightening of left border of heart ? Valvular heart disease , but clinical exam and ECHO does not show any Valvular heart disease ECHO shows low ejection fraction ,?Cardiomyopathy ? POST PARTUM CARDIOMYOPATHY with cardiac failure . CARDIAC opinion

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Hyperinflated lung fields bilateral Cardiomegaly Prominent pulmonary conus Lvef 30% Acute lt atrial dilatation with LVF You have not mentioned or posted ecg

ECG showing only sinus tachycardia.
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It's a case of Peripartum cardiomyopathy. It's cause is not well understood. Usually occurs in last trimester to first 6months of delivery. Risk factors include multipara, increasing age, malnutrition. Usually present with SOB. On CXR, you will find cardiomegaly. On echocardiography you will find EF less than 45% Dialated LV All valves normal Treat with diuretics, ACEI or ARB only after delivery. BB once patient is stablizes,not in acute failure. Selenium/zinc Antioxidant Bromocriptin is under investigation

PUERPRIAL CARDIOMYOPATHY RX SALT & FLUID RESTRICTION TAB. LASIX 40 MG OD ALDACTONE 25 MG OD METOPROLOL 25 MG OD

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Bilatreally hyperinflated lungs Cardiomegaly Straightening of lt border of heart ?postpartum cardiomyopathy

Postpartum Cardiomyopathy

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Cardiomegaly Valvular heart disease Put on digoxin & diuretics O2 s o s

Echo shows all valves normal.
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POST PARTUM CARDIOMYOPATHY

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, ecgmust cardiomegaly with COPD fraction 30 do angiography

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PUERPERIAL CARDIOMYOPATHY CHF RX FLUID & SALT RESTRICTION LASIX ALDACTONE ¹BETA BLOCKER

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