Dirençli ventriküler fibrilasyon ile karakterize postpartum kardiyomyopati

Yıl 2011, Cilt: 28 Sayı: 4, 182 - 185, 27.01.2012

Muhittin Çalım Cihan Bolat Hülya Tür Tülin Akarsu Ayazoğlu

https://doi.org/10.5835/jecm.omu.28.04.011

Öz

Postpartum kardiyomyopati sık görülmeyen, gebeliğin son ayı ile doğumdan sonraki ilk 5 ay içerisinde gözlenen dilate kardiyomyopati olup nedeni bilinmemektedir. Etyolojide hormonal bozukluk, koroner spazm, viral, otoimmün ve idiyopatik miyokardit, hipertansiyon, apoptosis, genetik, inflamatuar sitokinlerin aktivasyonu hipotezleri sayılmaktadır. Gebelik kardiomyopatisinde yüksek mortalite ile ilişkilidir( aralık %20-50 arasında). Biz bu vaka takdiminde; nefes darlığı ve çarpıntı şikayetleri ile yoğun bakıma yatırılan postpartum dilate kardiyomyopati tanısı konan 25 yaşında olgunun dirençli VF atakları, transvenöz geçici pace-maker, intra aortik balon pompa desteği ve başarılı ortotropik kalp transplantasyonunu anlattık.

Anahtar Kelimeler

Postpartum cardiomyopathy, diagnosis, treatment

Kaynakça

• Abboud, J., Murad, Y., Chen-Scarabelli, C., Saravolatz, L., Scarabelli, T.M., 2007. Peripartum cardiomypathy: a comprehensive review. Int. J. Cardiol. 118, 295-303
• Albanesi Fo, F.M., Silva, T.T., 1999. O comportamento das gestações subseqüentes na cardiomiopatia periparto. Arq. Bras. Cardiol. 73, 47-52.
• Bhakta, P., Biswas, B.K., Banerjee, B., 2007. Peripartum cardiomyopathy: review of the literature. Yonsei Med. J. 48, 731-747.
• Bosch, T., 2005. Therapeutic apheresis state of the art in the year. Ther. Apher. Dial. 9, 459-468.
• Davidson, N.M., Parry, E.H., 1979. The etiology of peripartum cardiac failure. Ann. Heart J. 97, 535-536.
• Demakis, J.G., Rahimtoola, S.H, Sutton, G.C., 1971. Natural course of peripartum cardiomyopathy. Circulation. 44, 1053-1061.
• Dickstein, K., Cohen-Solal, A., Filippatos, G., McMurray, J.J., Ponikowski, P., 2008. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2008 of the European Society of Cardiology. 10, 933-989.
• Elkayam, U., Akhter, M.W., Singh, H.S., 2005. Pregnancy-Associated Cardiomyopathy: Clinical characteristics and a comparison between early and late presentation. Circulation. 111, 2050-2055.
• Elliott, P., Andersson, B., Arbustini, E., 2008. Classification of the cardiomyopathies: a position statement from the European Society Of Cardiol- ogy Working Group on Myocardial and Pericardial Diseases. Eur. Heart J. 29, 270-276.
• Fekler, G.M., Jaeger, C.J., Klodas, M., 2000. Myocarditis and longterm survival in peripartum cardiomyopathy. Ann. Heart J. 140, 785-791.
• Felix, S.B., Staudt, A., 2006. Non-specific immunoadsorption in patients with dilated cardiomyopathy: mechanisms and clinical effects. Int. J. Cardiol. 112, 30-33.
• Fennira, S., Demiraj, A., Khouaja, A., Boujnah, M.R., 2006. Peripartum cardiyomyopathy. Ann. Cardiol. Angeiol. 55, 271-275.
• Jessup, M., Brozena, S., 2003. Heart failure. N. Engl. J. Med. 348, 2007-2018.
• Kowara, M.L., Dudziak, M., Suchorzewska, J., 2001. Two cases of postpartum cardiomyopathy initially misdiagnosed for pulmonary embolism. Can. J. Anesth. 48, 773-774.
• Kuhl, U., Pauschinger, M., Schwimmbeck, P.L., 2003. Interferon-beta treatment eliminates cardiotropic viruses and improves left ventricular function in patients with myocardial persistence of viral genomes and left ventricular dysfunction. Circulation. 107, 2793-2798.
• Li, W.M., Liu, W., Gao, C., Zhou, B.G., 2006. Immunoregulatory effects of atorvastatin on experimental autoimmune myocarditis in Lewis rats. Immunol. Cell Biol. 84, 274-280.
• Liu, Z., Yuan, J., Yanagawa, B., Qiu, D., McManus, B.M., Yang, D., 2005. Coxsackie virus induced myocarditis: new trends in treatment. Expert. Rev. Anti Infect Ther. 3, 641-650.
• Navascues, A.R., Marin, R., Testa, A., Paneda, F., Grande, A.J., 2001 Preeclampsia and peripartum cardiomyopathy. Nefrologia. 21, 84-87.
• Palanzo, D.A., Baer, L.D., El-Banayosy, A., Stephenson, E., Mulvey, S., McCoach, R.M., Wise, R.K., Woitas, K.R., Pae, W.E., 2009. Successful treatment of peripartum cardiomyopathy with extracorporeal membrane oxygenation. Perfusion. 24, 75-79.
• Pearson, G.D., Veille, J.C., Rahimtoola, S., 2000. Peripartum cardiomyopathy National Heart, Lung and Blood Institute and Office of Rare Dis- eases (National Institutes of Health) workshop recommendations and review. J.A.M.A. 283, 1183-1188.
• Sahraoui, W., Hajji, S., Haouas, N., El Mejri, L., Slama, A., Ernez, S., 2007 . Peripartum cardiomyopathy. Tunis Med. 85, 473-478.
• Sliwa, K., Blauwet, L., Tibazarwa, K., Libhaber, E., Smedema, J.P., Becker, A., McMurray, J., Yamac, H., Labidi, S., Struman, I., Hilfiker- Kleiner, D., 2010. Evaluation of bromocriptine in the treatment of acute severe peripartum cardiomyopathy: a proof-of-concept pilot study. Circulation. 121, 1465-1473.
• Smith, I.J., Gillham, M.J., 2009. Fulminant peripartum cardiomyopathy rescue with extracorporeal membranous oxygenation. Int. J. Obstet. Anesth. 18, 186-188.
• Sutton, M.S.J., Cole, P., Plappert, M., 1991. Effects of subsequent pregnancy on left ventricular function in peripartum cardiomyopathy. Ann. Heart J. 121, 1776-1778.
• Tidswell, M. 2004. Peripartum cardiomyopathy. Crit. Care. Clin. 20, 777-778.
• Yang, H.S., Hong, Y.S., Rim, S.J., Yu, S.H., 2007. Extracorporeal membrane oxygenation in a patient with peripartum cardiomyopathy. Ann. Thorac. Surg. 84, 262-264.
• Yu, C.M., Abraham, W.T., Bax, J., Chung, E., Fedewa, M., Ghio, S., 2005. PROSPECT Investigators. Predictors of response to cardiac resyn- chronization therapy (PROSPECT)-study design. Ann. Heart J. 149, 600-605.
• Yuan, H.T., Liao, Y.H., Wang, Z., 2003. Prevention of myosin-induced autoimmune myocarditis in mice by anti-L3T4 monoclonal antibody. Can. J. Physiol. Pharmacol. 81, 84-88.
• Yuan, Z., Kishimoto, C., Shioji, K., 2003. Beneficial effects of low-dose benidipine in acute autoimmune myocarditis: suppressive effects on inflammatory cytokines and inducible nitric oxide synthase. Circulation J. 67, 545-550.
• Zimmerman, H., Bose, R., Smith, R., Copeland, J.G., 2010. Treatment of peripartum cardiomyopathy with mechanical assist devices and cardiac transplantation. Ann. Thorac. Surg. 89, 1211-1217.