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Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report

BACKGROUND: Acute post-partum dyspnea configures an obstetric challenge with multiple differential diagnosis. CASE PRESENTATION: We present a case of a previous healthy woman with preeclampsia who developed severe dyspnea 30 h after delivery. She complained of cough, orthopnea, and bilateral lower e...

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Autores principales: De Pinho, António, Mota De Sousa, Andreia, Melo, Anabela, Ferreira, Anabela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10316575/
https://www.ncbi.nlm.nih.gov/pubmed/37400772
http://dx.doi.org/10.1186/s12884-023-05809-w
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author De Pinho, António
Mota De Sousa, Andreia
Melo, Anabela
Ferreira, Anabela
author_facet De Pinho, António
Mota De Sousa, Andreia
Melo, Anabela
Ferreira, Anabela
author_sort De Pinho, António
collection PubMed
description BACKGROUND: Acute post-partum dyspnea configures an obstetric challenge with multiple differential diagnosis. CASE PRESENTATION: We present a case of a previous healthy woman with preeclampsia who developed severe dyspnea 30 h after delivery. She complained of cough, orthopnea, and bilateral lower extremities oedema. She denied headaches, blurry vision, nausea, vomiting, fever or chills. Auscultation revealed a diastolic murmur, and was compatible with pulmonary oedema. A timely bedside echocardiogram showed moderate dilated left atrium with severe mitral insufficiency suggestive of an unknown rheumatic disease. She was managed with noninvasive ventilation, loop diuretics, vasodilators, thromboprophylaxis, head-end elevation, and fluid restriction with progressive improving. CONCLUSIONS: Hemodynamic changes in pregnant patients with previously silent cardiac disease may pose a challenge and cause post-partum dyspnea. This scenario requires a timely and multidisciplinary approach.
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spelling pubmed-103165752023-07-04 Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report De Pinho, António Mota De Sousa, Andreia Melo, Anabela Ferreira, Anabela BMC Pregnancy Childbirth Case Report BACKGROUND: Acute post-partum dyspnea configures an obstetric challenge with multiple differential diagnosis. CASE PRESENTATION: We present a case of a previous healthy woman with preeclampsia who developed severe dyspnea 30 h after delivery. She complained of cough, orthopnea, and bilateral lower extremities oedema. She denied headaches, blurry vision, nausea, vomiting, fever or chills. Auscultation revealed a diastolic murmur, and was compatible with pulmonary oedema. A timely bedside echocardiogram showed moderate dilated left atrium with severe mitral insufficiency suggestive of an unknown rheumatic disease. She was managed with noninvasive ventilation, loop diuretics, vasodilators, thromboprophylaxis, head-end elevation, and fluid restriction with progressive improving. CONCLUSIONS: Hemodynamic changes in pregnant patients with previously silent cardiac disease may pose a challenge and cause post-partum dyspnea. This scenario requires a timely and multidisciplinary approach. BioMed Central 2023-07-03 /pmc/articles/PMC10316575/ /pubmed/37400772 http://dx.doi.org/10.1186/s12884-023-05809-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
De Pinho, António
Mota De Sousa, Andreia
Melo, Anabela
Ferreira, Anabela
Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report
title Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report
title_full Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report
title_fullStr Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report
title_full_unstemmed Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report
title_short Unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report
title_sort unknown rheumatic cardiac disease as cause of acute onset post-partum dyspnea: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10316575/
https://www.ncbi.nlm.nih.gov/pubmed/37400772
http://dx.doi.org/10.1186/s12884-023-05809-w
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