Peripartum cardiomyopathy and clinical masks of severe preeclampsia: Issues of differential diagnosis and management tactics
Background. Noncoronary heart diseases remain one of the least studied cardiologic problems, including those in pregnant women. The introduction of highly informative noninvasive diagnostic techniques, including echocardiography into clinical practice, could identify special nosological entities in a group of noncoronary diseases of the myocardium (cardiomyopathies).Ignatko I.V., Strizhakov L.A., Timokhina E.V., Afanasyeva N.V., Ryabova S.G.
Description. The paper presents a clinical case of peripartum cardiomyopathy (PPCM) in a 39-year-old pregnant woman and that of respiratory failure in a 29-year-old pregnant woman with severe preeclampsia that required a thorough diagnostic and differential diagnostic search for PPCM. It considers the pathogenesis of PPCM, the features and community of vasculopathy in PPCM and preeclampsia, diagnosis and differential diagnosis, the prediction of adverse outcomes, and therapy characteristics.
Conclusion. The timely diagnosis, differential diagnosis, consideration of all the classical clinical manifestations of the disease, and correct and pathogenetically grounded treatment may result in rapid relief of the signs of heart failure and pulmonary edema and in complete recovery of systolic function of the heart.
Keywords
peripartum cardiomyopathy
preeclampsia
pathogenesis
echocardiography
prognosis
therapy
Supplementary Materials
References
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Received 09.06.2017
Accepted 23.06.2017
About the Authors
Ignatko Irina Vladimirovna, Corresponding Member of the Russian Academy of Sciences, MD, Professor of the Department of Obstetrics, Gynecology and Perinatologyof the Faculty of Physiology, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia.
119435, Russia, Moscow, Bolshaya Pirogovskaya str. 2, bld. 4. Tel.: +74997824513, +79104617302. E-mail: iradocent@mail.ru
Strizhakov Leonid Alexandrovich, MD, Professor of the Department of Internal, Occupational Diseases and Pulmonology, I.M. Sechenov
First Moscow State Medical University, Ministry of Health of Russia. 119435, Russia, Moscow, Bolshaya Pirogovskaya str. 2, bld. 4. E-mail: strizhakov76@mail.ru
Timokhina Elena Vladimirovna, MD, Professor of the Department of Obstetrics, Gynecology and Perinatology of the Faculty of Physiology, I.M. Sechenov
First Moscow State Medical University, Ministry of Health of Russia. 119435, Russia, Moscow, Bolshaya Pirogovskaya str. 2, bld. 4. E-mail: elena.timokhina@mail.ru
Afanasyeva Natalia Vyacheslavovna, Candidate of Medical Science, Head of the maternity ward of the maternity hospital, S.S. Yudin State Clinical Hospital, Moscow Healthcare Department. 115487, Russia, Moscow, Ac. Millionshchikova str. 1. Tel.: +74997824513. E-mail: natalia1585@yandex.ru
Ryabova Svetlana Gennadievna, the doctor of the maternity department of the maternity hospital, S.S. Yudin State Clinical Hospital, Moscow Healthcare Department.
115487, Russia, Moscow, Ac. Millionshchikova str. 1. Tel.: +74997824513. E-mail: natalia1585@yandex.ru
For citations: Ignatko I.V., Strizhakov L.A., Timokhina E.V., Afanasyeva N.V., Ryabova S.G. Peripartum cardiomyopathy and clinical masks of severe preeclampsia: Issues of differential diagnosis and management tactics. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (11): 114-22. (in Russian)
https://dx.doi.org/10.18565/aig.2017.11.114-122
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