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Pregnancy in a Patient With Primary Dilated Cardiomyopathy

Department of Obstetrics and Gynecology, University of Saskatchewan, Saskatoon, Canada

Address reprint requests to: Ashraf Yacoub, MD, Royal University Hospital, Department of Obstetrics and Gynecology, 103 Hospital Drive, Saskatoon, Saskatchewan STN 0W8, Canada; E-mail: ashrafyacoub{at}hotmail.com.

ABSTRACT

BACKGROUND: Primary dilated cardiomyopathy is rare in women of childbearing age. The expected increase in intra-vascular volume and cardiac output during pregnancy is poorly tolerated by patients with primary dilated cardiomyopathy and may result in cardiac failure.

CASE: A primigravid teenager with a history of primary dilated cardiomyopathy developed severe acute cardiac failure at 20 weeks’ gestation. She required ventilation and was treated with inotropes and nitroglycerin. After counseling, she underwent termination of pregnancy using misoprostol. She recovered and was discharged 5 days after delivery.

CONCLUSION: Pregnancy in patients with primary dilated cardiomyopathy can be extremely hazardous, resulting in cardiac failure and even death. A multidisciplinary approach and consideration of termination of pregnancy may be required in management of such patients.

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				J. Arafeh and Y. Y. El-Sayed Cardiac Disease in Pregnancy NeoReviews, June 1, 2004; 5(6): e232 - e239. [Full Text] [PDF]