Case Report: Peripartum cardiomyopathy in a young female complicated by cardioembolic stroke

Ravi Ranjan Pradhan,Ajay Kumar Yadav,Sant Yadav,Prashant Kumar Gupta

doi:10.12688/f1000research.21712.1

Ravi Ranjan Pradhan, Ajay Kumar Yadav + Show 2 more

Open Access

https://doi.org/10.12688/f1000research.21712.1

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Journal: F1000Research	Publication Date: Dec 20, 2019
License type: CC BY 4.0

Affiliation: Shandong Provincial Hospital

Abstract

Stroke in a young female is rare but, when it occurs, has a serious economic, and mental burden to the patient, and family members. Peripartum cardiomyopathy (PPCM) is one of the rare causes of stroke in young females. We report a case of a 20-year-old female with PPCM complicated by cardioembolic stroke. The patient was started on long-term anticoagulation, and her heart failure regimen was optimized upon discharge. Anticoagulation therapy in cardioembolic stroke prevents further complications.

Highlights

Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure affecting women in late pregnancy or in the puerperium
Her heart failure (HF) medications were optimized, and anticoagulation with warfarin 5 mg daily was continued with provision for regular monitoring of prothrombin time (PT), and international normalization ratio (INR)
In a case report from Kumbham et al.[11] the patient had multifocal infarct involving the left frontoparietal lobe, both occipital lobes, and the right insular cortex as well as thrombi in the left ventricle, which is in contrast with our case

Summary

Introduction

Peripartum cardiomyopathy (PPCM) is a rare cause of heart failure affecting women in late pregnancy or in the puerperium. With the above symptoms the patient present at her local hospital, where she received injectable and oral antibiotics (intravenous ceftriaxone 1 gram twice a day and oral azithromycin 500 mg daily) thinking that it could be a chest infection. Her symptoms were not relieved and, she visited our center. On discharge, her HF medications were optimized (frusemide 20 mg twice a day, spironolactone 50 mg daily, and metoprolol 50 mg daily), and anticoagulation with warfarin 5 mg daily was continued with provision for regular monitoring of prothrombin time (PT), and international normalization ratio (INR).

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