Ventricular tachycardia revealing a peripartum cardiomyopathy in a 33-year-old new mother

Jospin Karel Bassakouahou Makani; Suzy Gisele Kimbally Kaky; Meo Stephane Ikama; Christian Michel Kouala Landa

doi:10.4103/njc.njc_29_19

CASE REPORT

Year : 2020 | Volume : 17 | Issue : 1 | Page : 82-83

Ventricular tachycardia revealing a peripartum cardiomyopathy in a 33-year-old new mother

Jospin Karel Bassakouahou Makani¹, Suzy Gisele Kimbally Kaky², Meo Stephane Ikama², Christian Michel Kouala Landa¹
¹ Department of Cardiology, Teaching Hospital of Brazzaville, Brazzaville, Congo
² Department of Cardiology, Teaching Hospital of Brazzaville; Department of Medicine, Faculty Health Science, Marien Ngouabi University, Brazzaville, Congo

Date of Submission	04-Nov-2019
Date of Decision	10-Mar-2020
Date of Acceptance	17-Mar-2020
Date of Web Publication	30-Jun-2020

Correspondence Address:
Dr. Jospin Karel Bassakouahou Makani
Department of Cardiology, Teaching Hospital of Brazzaville, Brazzaville
Congo

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/njc.njc_29_19

Abstract

We report a case of ventricular tachycardia due to peripartum cardiomyopathy in a 33-year-old woman. The clinical symptomatology was dominated by recurrent palpitations. Doppler echocardiography revealed dilated cardiac chambers and a left ventricular ejection fraction at 30%. Treatment with amiodarone led to cardioversion. Furosemide and captopril have been used to treat heart failure.

Keywords: Congo, peripartum cardiomyopathy, ventricular tachycardia

How to cite this article:
Makani JK, Kaky SG, Ikama MS, Kouala Landa CM. Ventricular tachycardia revealing a peripartum cardiomyopathy in a 33-year-old new mother. Nig J Cardiol 2020;17:82-3

How to cite this URL:
Makani JK, Kaky SG, Ikama MS, Kouala Landa CM. Ventricular tachycardia revealing a peripartum cardiomyopathy in a 33-year-old new mother. Nig J Cardiol [serial online] 2020 [cited 2023 May 30];17:82-3. Available from: https://www.nigjcardiol.org/text.asp?2020/17/1/82/288649

Introduction

Peripartum cardiomyopathy is a heart failure occurring in a woman between the last month of pregnancy and the 5^th month after delivery in a patient without a history of heart disease. This condition is more common in African and afro-American women.^[1],[2] The special issue of this case is the occurrence of ventricular tachycardia, rarely reported in the literature.^[3],[4]

Case Report

A 33-year-old woman and nurse of 5 months consulted at the Department of Cardiology in the teaching hospital of Brazzaville, for a first episode of dyspnea and recurrent palpitations which started 2 days ago. The interrogation did not find a history of heart disease in the patient. She has previously completed two pregnancies without complications. At admission, the heart rhythm was constant and heart rate at 200 beats per minute. Blood pressure was 100/80 mmHg. Pleuropulmonary auscultation was normal. Painful hepatomegaly (hepatic spine = 16 cm) and hepatic jugular reflux were noted. The rest of the physical examination was borderline. The 12-lead electrocardiogram recorded a regular tachycardia (heart rate: 197 beats per minute) with wide QRS complexes and atrioventricular dissociation [Figure 1].

Figure 1: Electrocardiogram showing ventricular tachycardia

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Front chest X-ray showed cardiomegaly (cardiothoracic ratio = 66%) and interstitial pulmonary edema.

The Doppler echocardiogram revealed global hypokinesia, with an ejection fraction at 30%, dilated left cardiac cavities (left ventricular [LV] =69.4 mm, left atrium = 22 cm²) [Figure 2], and functional mitral insufficiency Grade 2. The biology was normal.

Figure 2: Transthoracic echocardiography showing global hypokinesia and left cardiac dilatation

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Global heart failure and sustained ventricular tachycardia due to peripartum cardiomyopathy was the final diagnosis. The resort to medical cardioversion by amiodarone was applied, allowing immediate return to sinus rhythm. Furosemide and captopril have been used for the management of heart failure.

Discussion

Peripartum cardiomyopathy is a relatively common condition in African and afro-American women.^[1],[2] The clinical presentation is dominated by symptoms of heart failure.^[1],[4] For Diao et al. in Dakar,^[4] the rhythm disorders frequently noted on a 24-h recording were: sinus tachycardia, ventricular, and supraventricular extrasystoles. Otherwise, Duncker et al. in Gremany^[5] established that the risk of ventricular arrhythmias was high in the early stage of peripartum cardiomyopathy and seems to be correlated with severe reduction of LV ejection fraction. In addition, data from the literature indicate that the first case of postural tachycardia syndrome associated with peripartum cardiomyopathy was reported by Kimpinski et al. in the United States.^[6] Sustained ventricular tachycardia, as noted in our patient, has been rarely reported.^[3]

Conclusion

Serious ventricular arrhythmias are rare during peripartum cardiomyopathy. It is, therefore, important to look for them by using long-term electrocardiographic recording to improve the prognosis of patients.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

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2.	Gentry MB, Dias JK, Luis A, Patel R, Thornton J, Reed GL. African-American women have a higher risk for developing peripartum cardiomyopathy. J Am Coll Cardiol 2010;55:654-9.
3.	Puri A, Sethi R, Singh B, Dwivedi S, Narain V, Saran R, et al. Peripartum cardiomyopathy presenting with ventricular tachycardia: A rare presentation. Indian Pacing Electrophysiol J 2009;9:186-9.
4.	Diao M, Diop IB, Kane A, Camara S, Kane A, Sarr M and et al. Long-term recording of 24-hour during peripartum cardiomyopathy. Arch Mal Cœur Vaiss 2004;97:25-30.
5.	Duncker D, Haghikia A, König T, Hohmann S, Gutleben KJ, Westenfeld R, et al. Risk for ventricular fibrillation in peripartum cardiomyopathy with severely reduced left ventricular function-value of the wearable cardioverter/defibrillator. Eur J Heart Fail 2014;16:1331-6.
6.	Kimpinski K, Iodice V, Low PA. Postural tachycardia syndrome associated with peripartum cardiomyopathy. Auton Neurosci 2010;155:130-1.