Case report: the management for a gestational hypertensive woman with influenza A virus pneumonia and peripartum cardiomyopathy
Abstract Background Peripartum cardiomyopathy (PPCM) is defined as an idiopathic cardiomyopathy occurring in the last month of pregnancy or the first 6 months postpartum without an identifiable cause. PPCM is suspected to be triggered by the generation of a cardiotoxic fragment of prolactin and the...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-04814-9 |
| _version_ | 1811341691733409792 |
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| author | Kwok-On Ng Lok-Hi Chow Chun-Chang Yeh Eagle Yi-Kung Huang Wei-Cheng Liu Ping-Heng Tan |
| author_facet | Kwok-On Ng Lok-Hi Chow Chun-Chang Yeh Eagle Yi-Kung Huang Wei-Cheng Liu Ping-Heng Tan |
| author_sort | Kwok-On Ng |
| collection | DOAJ |
| description | Abstract Background Peripartum cardiomyopathy (PPCM) is defined as an idiopathic cardiomyopathy occurring in the last month of pregnancy or the first 6 months postpartum without an identifiable cause. PPCM is suspected to be triggered by the generation of a cardiotoxic fragment of prolactin and the secretion of a potent antiangiogenic protein from the placental, but no single factor has been identified or defined as the underlying cause of the disease. Influenza virus can cause PPCM through immune-mediated response induced by proinflammatory cytokines from host immunity and endothelial cell dysfunction. We report a case in a parturient woman undergoing a cesarean delivery, who had influenza A pneumonia and PPCM. Case presentation A parturient woman at 40 weeks and 1 day of gestation who had experienced gestational hypertension accompanied by pulmonary edema developed hypotension after undergoing an emergency cesarean delivery. An elevation of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was noted, and echocardiography revealed a left ventricular ejection fraction of 20%. She underwent a nasopharyngeal swab test, in which influenza A antigen was positive. She was diagnosed as having PPCM and received anti-viral treatment. After antiviral treatment, hemodynamic dysfunction stabilized. We present and discuss the details of this event. Conclusion PPCM is a heart disease that is often overlooked by medical personnel. Rapid swab tests, serum creatine kinase measurement, and echocardiography are imperative diagnostic approaches for the timely recognition of virus-associated cardiomyopathy in peripartum women with influenza-like disease and worsening dyspnea, especially during the epidemic season. Prompt antiviral treatment should be considered, particularly after PPCM is diagnosed. |
| first_indexed | 2024-04-13T18:57:44Z |
| format | Article |
| id | doaj.art-f3257d5d69b9463fb50472f8b5a4f330 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-04-13T18:57:44Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-f3257d5d69b9463fb50472f8b5a4f3302022-12-22T02:34:11ZengBMCBMC Pregnancy and Childbirth1471-23932022-06-012211610.1186/s12884-022-04814-9Case report: the management for a gestational hypertensive woman with influenza A virus pneumonia and peripartum cardiomyopathyKwok-On Ng0Lok-Hi Chow1Chun-Chang Yeh2Eagle Yi-Kung Huang3Wei-Cheng Liu4Ping-Heng Tan5Department of Anesthesiology, Ditmanson Medical Foundation Chia-Yi Christian HospitalDepartment of Anesthesiology, School of Medicine, Taipei Veterans General Hospital, and National Yang-Ming Chiao-Tung UniversityDepartment of Anesthesiology of Tri-Service General Hospital &, National Defense Medical CenterDepartment of Pharmacology, National Defense Medical CenterDepartment of Anesthesiology, Chi Mei Medical CenterDepartment of Anesthesiology, Chi Mei Medical CenterAbstract Background Peripartum cardiomyopathy (PPCM) is defined as an idiopathic cardiomyopathy occurring in the last month of pregnancy or the first 6 months postpartum without an identifiable cause. PPCM is suspected to be triggered by the generation of a cardiotoxic fragment of prolactin and the secretion of a potent antiangiogenic protein from the placental, but no single factor has been identified or defined as the underlying cause of the disease. Influenza virus can cause PPCM through immune-mediated response induced by proinflammatory cytokines from host immunity and endothelial cell dysfunction. We report a case in a parturient woman undergoing a cesarean delivery, who had influenza A pneumonia and PPCM. Case presentation A parturient woman at 40 weeks and 1 day of gestation who had experienced gestational hypertension accompanied by pulmonary edema developed hypotension after undergoing an emergency cesarean delivery. An elevation of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was noted, and echocardiography revealed a left ventricular ejection fraction of 20%. She underwent a nasopharyngeal swab test, in which influenza A antigen was positive. She was diagnosed as having PPCM and received anti-viral treatment. After antiviral treatment, hemodynamic dysfunction stabilized. We present and discuss the details of this event. Conclusion PPCM is a heart disease that is often overlooked by medical personnel. Rapid swab tests, serum creatine kinase measurement, and echocardiography are imperative diagnostic approaches for the timely recognition of virus-associated cardiomyopathy in peripartum women with influenza-like disease and worsening dyspnea, especially during the epidemic season. Prompt antiviral treatment should be considered, particularly after PPCM is diagnosed.https://doi.org/10.1186/s12884-022-04814-9Peripartum cardiomyopathyCaesarean sectionPneumoniainfluenza A |
| spellingShingle | Kwok-On Ng Lok-Hi Chow Chun-Chang Yeh Eagle Yi-Kung Huang Wei-Cheng Liu Ping-Heng Tan Case report: the management for a gestational hypertensive woman with influenza A virus pneumonia and peripartum cardiomyopathy BMC Pregnancy and Childbirth Peripartum cardiomyopathy Caesarean section Pneumonia influenza A |
| title | Case report: the management for a gestational hypertensive woman with influenza A virus pneumonia and peripartum cardiomyopathy |
| title_full | Case report: the management for a gestational hypertensive woman with influenza A virus pneumonia and peripartum cardiomyopathy |
| title_fullStr | Case report: the management for a gestational hypertensive woman with influenza A virus pneumonia and peripartum cardiomyopathy |
| title_full_unstemmed | Case report: the management for a gestational hypertensive woman with influenza A virus pneumonia and peripartum cardiomyopathy |
| title_short | Case report: the management for a gestational hypertensive woman with influenza A virus pneumonia and peripartum cardiomyopathy |
| title_sort | case report the management for a gestational hypertensive woman with influenza a virus pneumonia and peripartum cardiomyopathy |
| topic | Peripartum cardiomyopathy Caesarean section Pneumonia influenza A |
| url | https://doi.org/10.1186/s12884-022-04814-9 |
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