Abstract
Peripartum cardiomyopathy is a relatively rare condition, that usually presents with features of heart failure in the peripartum period. The ongoing pandemic caused by coronavirus disease 2019 (COVID-19) has been reported to be associated with myocarditis, with progression to dilated cardiomyopathy and heart failure. Dilated cardiomyopathy in a peripartum patient with COVID-19 infection may present a diagnostic dilemma. We report a case of dilated cardiomyopathy in a peripartum patient with COVID-19 infection. She presented with shortness of breath in the peripartum period. Chest X-ray showed a grossly enlarged heart with bilateral pulmonary infiltrates consistent with congestive heart failure or viral pneumonia. Echocardiography revealed dilated chambers with 22% left ventricular ejection fraction (LVEF) and global hypokinesis. Despite completing 5 days of remdesivir and dexamethasone, she had worsening dyspnea on postpartum day 10, a repeat echocardiogram showed further reduction in LVEF to 10-15% and was discharged with a life-vest after acute management. She had multiple hospital admissions for decompensated heart failure. Myocardial core biopsy showed marked acute inflammation and necrosis. She had an intra-aortic balloon pump, left ventricular and right ventricular assist devices placed on account of persistent hemodynamic instability, and is now scheduled to have a cardiac transplant.
【저자키워드】 COVID-19, heart failure, Cardiomyopathy, Peripartum cardiomyopathy, 【초록키워드】 Dexamethasone, coronavirus disease, Necrosis, Coronavirus disease 2019, pandemic, Infection, diagnostic, Remdesivir, Acute inflammation, progression, Case report, echocardiography, Viral pneumonia, X-ray, COVID-19 infection, myocarditis, management, Dyspnea, Hospital admission, congestive heart failure, women, COVD-19, dilated cardiomyopathy, Shortness of breath, Echocardiogram, Ejection fraction, worsening, LVEF, hemodynamic instability, inflammatory disease, patient with COVID-19, feature, highlight, caused, reported, reduction in, discharged, assist, bilateral pulmonary infiltrate, decompensated heart failure, multiple organ, ventricular,