Peripartum Cardiomyopathy with Heart Failure Persisting Beyond Ten Months Post-Partum: A Rare Case Report in Awka, Nigeria

Abstract

Peripartum cardiomyopathy (PPCM) is a rare dilated cardiomyopathy that occurs in late pregnancy or in post-partum period. The features of PPCM usually resolve within six months post-partum following treatment. Factors associated with PPCM are not completely known. We document a rare case of PPCM with features that persisted beyond 10 months post-partum despite medical treatment, in a 38 year-old woman in Awka, Nigeria. The patient, 38 years old, presented in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, Nigeria, with features of heart failure in the 8 ^th month of pregnancy, without antecedent history of cardiac disease. Her parity was 5 including a set of twins in this index pregnancy. X-ray showed features of heart failure. Echocardiography revealed features of dilated cardiomyopathy. Diagnosis of PPCM was made. She was placed on anti-heart failure regimen. She has remarkable improvement but not complete recovery of heart failure features on three months of follow-up, and 10 months post-partum. This case report of PPCM occurring as the first case in five years in our center shows that PPCM is rare in southeast Nigeria. It further shows that heart failure in PPCM may not resolve completely 10 months post-partum, despite adequate treatment. There is a need for further search for etiology and associations.