Srpski arhiv za celokupno lekarstvo 2016 Volume 144, Issue 1-2, Pages: 77-80
https://doi.org/10.2298/SARH1602077C
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Peripartum cardiomyopathy in a patient treated for acute myeloid leukemia
Čolović Nataša (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Hematology, Belgrade)
Seferović Petar (School of Medicine, Belgrade + Clinic for Cardiology, Clinical Center of Serbia, Belgrade)
Plećić Miroslava (Health Center, Valjevo)
Vidović Ana (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Hematology, Belgrade)
Suvajdžić Nada (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Hematology, Belgrade)
Tomin Dragica (School of Medicine, Belgrade + Clinical Center of Serbia, Clinic for Hematology, Belgrade)
Introduction. Peripartum cardiomyopathy usually presents with systolic heart
failure during the last months of pregnancy and up to five months postpartum.
The disease is rare and can be fatal. Case Outline. We report a 30-year-old
female who was diagnosed with acute myeloid leukemia, with maturation and
cytogenetic finding of t(8;21)(q22;q22),del(9)(q22) in January 2004. She was
treated with chemotherapy and achieved complete remission that lasts to date.
She became pregnant and delivered a healthy newborn with caesarean section in
2009. Seven months later, she again became pregnant and delivered the second
child with caesarean section in January 2011. Seven days after delivery she
developed symptoms and signs of heart failure. Electrocardiogram showed sinus
rhythm, low voltage and negative T-waves in inferior and lateral leads.
Echocardiography revealed global left ventricular dysfunction with ejection
fraction of 15%, with mobile thrombotic mass of 12 mm attached to the left
ventricle wall. She was treated with both unfractionated and low-molecular
heparin, diuretics, cardiotonics, and beta-blockers. Within six following
weeks left ventricle systolic function improved up to 25-30%. The full
clinical recovery was achieved in September 2013, resulting in absence of
heart failure and left ventricular ejection fraction of 54%. Conclusion.
Peripartum cardiomyopathy is a rare condition. The cause of cardiomyopathy is
unknown, but it is believed that it could be triggered by various conditions
and risk factors. Although the patient was treated with cardiotoxic drugs
(doxorubicin and mitoxantrone) in permitted doses, they could have been
contributory factors of myocardial damage. Close monitoring of cardiac
function in the peripartal period might be beneficial in patients treated
with cardiotoxic drugs.
Keywords: peripartum, cardiomyopathy, acute myeloid leukemia
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