[Development of biventricular large apical thrombi and cerebral embolism in a young woman with peripartum cardiomyopathy]

Turk Kardiyol Dern Ars. 2011 Oct;39(7):591-4. doi: 10.5543/tkda.2011.01534.
[Article in Turkish]

Abstract

Peripartum cardiomyopathy is a rare cardiac disorder. Although left ventricular apical thrombus formation is common in peripartum cardiomyopathy, biventricular apical thrombi formation is a very rare condition in these patients. A 21-year-old woman presented with complaints of dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and palpitations that appeared three months after labor. Transthoracic echocardiography showed severe global hypokinesis, decreased left and right ventricular ejection fraction (left 30%, right 35%), increased left ventricular end-diastolic dimension (60 mm), grade 2 mitral regurgitation, and biventricular apical thrombi. On the second day of admission, she developed global aphasia and right hemiplegia. The patient was successfully treated with recombinant tissue plasminogen activator. Transthoracic echocardiography following treatment showed disappearance of biventricular apical thrombi. She had no neurologic deficit. Treatment for heart failure was continued due to persistence of global hypokinesis and left ventricular dilatation.

MeSH terms

  • Cardiomyopathies / diagnosis*
  • Cardiomyopathies / diagnostic imaging
  • Cardiomyopathies / drug therapy
  • Diagnosis, Differential
  • Dyspnea
  • Echocardiography, Transesophageal
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Heart Atria
  • Humans
  • Intracranial Embolism / diagnosis*
  • Intracranial Embolism / drug therapy
  • Puerperal Disorders / diagnosis*
  • Puerperal Disorders / diagnostic imaging
  • Puerperal Disorders / drug therapy
  • Tachycardia
  • Thrombosis / diagnosis*
  • Thrombosis / diagnostic imaging
  • Thrombosis / drug therapy
  • Tissue Plasminogen Activator / therapeutic use
  • Young Adult

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator