Postpartum-Cardiomyopathy With Severe Hypocalcemia And Tetany

Abstract

We present a case of postpartum cardiomyopathy who presented with carpopedal spasm 72 hours after undergoing a caesarian section under spinal anaesthesia. A 25 year old primigravida with mild PIH was posted for emergency LSCS for CPD in labor. LSCS was done under spinal anaesthesia, later converted to GA for internal iliac artery ligation due to atonic uterus. Intraoperative vital parameters were stable, end operatively patient was shifted to ICU and extubated after 2 hours of ventilatory support. 3 days later, she had repeated episodes of carpopedalspasm, not responding to IV calcium infusion and progressed to laryngospasm requiring intubation. The patient had tachypnoea with respiratory alkalosis during this period. Serial X-rays showed progressively increasing bilateral infiltrates suggesting cardiac failure. Echocardiography was done which revealed severe LV dysfunction and a diagnosis of Postpartum Cardiomyopathy was made.