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cardiomyopathy in pregnancy

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https://www.readbyqxmd.com/read/27881700/veno-venous-ecmo-as-a-safe-bridge-to-recovery-in-a-patient-with-severe-peripartum-cardiomyopathy-learning-from-errors
#1
Christopher Ull, Thomas Armin Schildhauer, Justus T Strauch, Andreas Mügge, Justyna Swol
Peripartum cardiomyopathy (PPCM) is a rare disorder of unknown etiology and pathogenesis. The most important tool for diagnostic confirmation is transthoracic echocardiography. The recommended management of PPCM in pregnancy is summarized by the European Society of Cardiology Heart Failure Guidelines. Few data exist on the treatment of patients with fulminant PPCM and the need for extracorporeal membrane oxygenation (ECMO) in this context. We report on a young multiparous woman with cardiogenic shock caused by severe PPCM who was successfully, but atypically, supported with veno-venous ECMO as a bridge to recovery immediately after the birth of her third child...
November 23, 2016: Perfusion
https://www.readbyqxmd.com/read/27871237/a-unique-association-of-arrhythmogenic-right-ventricular-dysplasia-and-acute-myocarditis-as-assessed-by-cardiac-mri-a-case-report
#2
Andrea Ponsiglione, Marta Puglia, Carmine Morisco, Luigi Barbuto, Antonio Rapacciuolo, Mario Santoro, Letizia Spinelli, Bruno Trimarco, Alberto Cuocolo, Massimo Imbriaco
BACKGROUND: Arrhythmogenic right ventricular dysplasia (ARVD), is a genetic disorder of the heart, which mainly involves the right ventricle. It is characterized by hypokinetic areas at the free wall of the right ventricle (RV) or both ventricles, where myocardium is replaced by fibrous or fatty tissue. ARVD is an important cause of ventricular arrhythmias in children and young adults. Although the transmission of the disease is based on hereditary, in young adults it may not show any symptoms...
November 21, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27855048/-relationship-between-the-level-of-maternal-glycated-hemoglobin-and-fetal-hypertrophic-cardiomyopathy
#3
Karla Lucía Sánchez-Martínez, Luis Fernando Oseguera-Torres, Joel Ávalos-Nuño
BACKGROUND: Diabetes mellitus is a metabolic disorder commonly associated with pregnancy. It is shown that as the management of diabetes during pregnancy is optimized, decreases the frequency and severity of fetal and neonatal complications. The aim of this paper is to identify the relation between the level of maternal glycated hemoglobin and fetal hypertrophic cardiomyopathy. METHODS: An analitytic cross-sectional study was conducted. It included patients with single pregnancy of 28-37 weeks diagnosed with gestational or preconception diabetes mellitus...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27830098/a-pregnancy-with-severe-hypertrophic-obstructive-cardiomyopathy-after-surgery-for-an-implantable-cardioverter-defibrillator-a-case-report-and-literature-review
#4
Takashi Mitsui, Hisashi Masuyama, Kentaro Ejiri, Kei Hayata, Hiroshi Ito, Yuji Hiramatsu
Hypertrophic obstructive cardiomyopathy (HOCM) is cardiac hypertrophy of ventricular myocardium with left ventricular outflow tract obstruction. We report a pregnancy with HOCM after defibrillator implantation surgery. The patient was a 33-year-old nulligravida and was categorized as New York Heart Association class II. Her brain natriuretic peptide (BNP) level was 724.6 pg/dL at preconception. She received careful pregnancy management. However, because frequent uterine contractions were observed at 25 weeks and 6 days of pregnancy, she was hospitalized, and magnesium sulfate was started as a tocolytic agent...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27829880/immunosuppression-therapy-in-the-management-of-peripartum-cardiomyopathy-a-case-series-and-literature-review
#5
Joyee Basu, Christopher Redman, Oliver Ormerod
Peripartum cardiomyopathy is a heart failure syndrome occurring late in pregnancy or during the early post-natal period. The pathophysiology of peripartum cardiomyopathy is not fully understood and various mechanisms have been postulated including an underlying inflammatory process. We here report four cases presenting with acute left ventricular systolic dysfunction. Three out of four of the patients presented with a left ventricular ejection fraction <30% and one with a left ventricular ejection fraction of 35%...
December 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27824310/-diagnosis-and-treatment-of-stroke-during-pregnancy
#6
Melinda Vanya, Ivan Devosa, Delia Szok, Gyorgy Bartfai
Stroke, the sudden onset of brain dysfunction from a vascular cause, is one of the most common causes of long-term disability. Although rare during childbearing years, stroke is even more devastating when it occurs in a young woman trying to start a family. Pregnancy and the postpartum period are associated with an increased risk of ischemic stroke and intracerebral hemorrhage, although the incidence estimates have varied. There are several causes of stroke that are in fact unique to pregnancy and the postpartum period, such as preeklampszia and eklampszia, amniotic fluid embolus, postpartum angiopathy and postpartum cardiomyopathy...
September 2016: Neuropsychopharmacologia Hungarica
https://www.readbyqxmd.com/read/27813120/prediction-of-neonatal-outcome-of-ttts-by-fetal-heart-and-doppler-ultrasound-parameters-before-and-after-laser-treatment
#7
A Delabaere, F Leduc, Q Reboul, F Fuchs, S Wavrant, J C Fouron, F Audibert
OBJECTIVES: To determine the prognostic value of fetal Doppler and echocardiographic parameters for neonatal survival up to 30 days after laser coagulation in monochorionic pregnancies complicated by twin-twin transfusion syndrome (TTTS). METHODS: Fetal echocardiography and outcome data of consecutive cases of TTTS treated by laser were retrospectively reviewed. Hemodynamic and cardiac function parameters were collected before and after laser. RESULTS: Between February 2006 and January 2015, 106 fetoscopic laser were performed...
November 3, 2016: Prenatal Diagnosis
https://www.readbyqxmd.com/read/27790717/in-utero-coxsackievirus-b4-infection-of-the-mouse-thymus
#8
Hela Jaïdane, Aymen Halouani, Habib Jmii, Firas Elmastour, Saïda Abdelkefi, Gwennaëlle Bodart, Hélène Michaux, Tahar Chakroun, Famara Sane, Moncef Mokni, Vincent Geenen, Didier Hober, Mahjoub Aouni
Type B Coxsackievirus (CV-B) infections are frequently involved in the triggering of several autoimmune diseases such as myocarditis, dilated cardiomyopathy, pericarditis, pancreatitis, type 1 diabetes, encephalitis, thyroiditis, or Sjögren's syndrome. Serological and virological evidence suggests that maternal infections during pregnancy can play a role in the appearance of these diseases in offspring. The current study aims to explore the effect of an in utero CV-B infection on the fetal thymus, the central site for programming immunological self-tolerance...
October 28, 2016: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/27756175/pregnancies-complicated-by-both-preeclampsia-and-growth-restriction-between-34-and-37-weeks-gestation-are-associated-with-adverse-perinatal-outcomes
#9
Kathryn J Sharma, Tania F Esakoff, Alyson Guillet, Richard M Burwick, Aaron B Caughey
OBJECTIVE: To determine whether adverse outcomes were more common in late preterm pregnancies complicated by preeclampsia and growth restriction compared to those affected by preeclampsia alone. METHODS: This was a retrospective cohort study of 8,927 singleton pregnancies with preeclampsia. Pregnancies with small for gestational age (SGA) neonates (birthweight <10(th) percentile) were compared to those appropriate for gestational age (AGA) neonates. Maternal outcomes included cesarean delivery (CD) rate, CD for fetal heart rate (FHR) abnormalities, abruption, postpartum hemorrhage (PPH), maternal transfusion, acute renal failure, and peripartum cardiomyopathy...
October 19, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27754119/os-23-06-can-left-ventricular-torsional-mechanics-using-speckle-tracking-echocardiography-in-pregnancy-to-predict-the-new-onset-heart-failure
#10
Krasimira Hristova, Rumen Marinov, Georgi Stamenov, Kristina Chacheva, Marina Michova, Sabina Persenska, Ani Racheva
OBJECTIVE: Normal pregnancy is associated with reversible changes in both systolic and diastolic mechanics, consistent with an increase in preload and decrease in afterload and systemic vascular resistance. The aim is to evaluate left ventricular (LV) twist and untwist mechanics in a population of pregnant women during differing stages of a healthy pregnancy. DESIGN AND METHOD: We included 22 pregnant patients, 10 with multiple pregnancy (mean age 36.5 ± 3 years) and 20 healthy non pregnant women (mean age 33 ± 4years)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27742423/reproductive-history-of-women-with-takotsubo-cardiomyopathy
#11
Elena Salmoirago-Blotcher, Shira Dunsiger, Heather H Swales, Gerard P Aurigemma, Ira Ockene, Lindsey Rosman, Ilan S Wittstein
Takotsubo cardiomyopathy (TC) occurs predominantly in postmenopausal women, suggesting a possible role of reproductive and hormonal factors in the pathophysiology of this condition. Yet reproductive characteristics of women with TC have received limited attention. This prospective case-control study sought to explore reproductive characteristics associated with TC. Incident TC cases and myocardial infarction (MI) controls were recruited among consecutive women presenting at the emergency departments of 2 large medical centers in Massachusetts and Connecticut...
September 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27741366/the-diverse-outcome-of-early-prenatal-diagnosis-of-pulmonary-stenosis
#12
Moshe Bronshtein, Zeev Blumenfeld, Asaad Choury, Ayala Gover
OBJECTIVES: To assess the natural history and outcome of fetal pulmonary stenosis [PS] detected at 14 to 16 weeks gestation. METHODS: This is a retrospective study, in the years 2004-2015, with serial follow up during pregnancy. Patients referred for complete early fetal ultrasound including all fetal systems and a fetal echocardiogram. Ninety seven percent of the women were low risk, and 3% had risk factors such as maternal type 1 diabetes mellitus, exposure to teratogenic drugs or anomalies in previous pregnancies or in other family members...
October 14, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27682655/epidemiology-of-hypertensive-disorders-in-pregnancy-prevalence-risk-factors-predictors-and-prognosis
#13
Mitsumasa Umesawa, Gen Kobashi
Hypertensive disorders in pregnancy (HDP) represent some of the most important problems faced by public health because HDP is a major cause of maternal and prenatal morbidity and mortality. Several epidemiological studies have been performed to determine the prevalence and risk factors of HDP as well as its subtypes. The prevalences of HDP, gestational hypertension and preeclampsia are 5.2-8.2%, 1.8-4.4% and 0.2-9.2%, respectively. Body mass index, anemia and lower education appear to be modifiable risk factors for HDP...
September 29, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27671176/peripartum-cardiomyopathy-in-a-pakistani-cohort
#14
Rubab Munir, Sajjad Hussain, Azhar Mahmood Kayani
OBJECTIVE: To describe the demographics, risk factors, and clinical presentation in Pakistani patients with peripartum cardiomyopathy. STUDY DESIGN: A descriptive observational study. PLACE AND DURATION OF STUDY: Rawalpindi Institute of Cardiology, Rawalpindi, from June 2014 to June 2015. METHODOLOGY: Seventy patients meeting criteria of peripartum cardiomyopathy were included in the study. Adetailed history, physical examination and investigations were done...
September 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27643046/os-23-06-can-left-ventricular-torsional-mechanics-using-speckle-tracking-echocardiography-in-pregnancy-to-predict-the-new-onset-heart-failure
#15
Krasimira Hristova, Rumen Marinov, Georgi Stamenov, Kristina Chacheva, Marina Michova, Sabina Persenska, Ani Racheva
OBJECTIVE: Normal pregnancy is associated with reversible changes in both systolic and diastolic mechanics, consistent with an increase in preload and decrease in afterload and systemic vascular resistance. The aim is to evaluate left ventricular (LV) twist and untwist mechanics in a population of pregnant women during differing stages of a healthy pregnancy. DESIGN AND METHOD: We included 22 pregnant patients, 10 with multiple pregnancy (mean age 36.5 ± 3 years) and 20 healthy non pregnant women (mean age 33 ± 4years)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27640989/third-trimester-foetal-complications-in-pregnancy-with-diabetes
#16
Vidushi Kulshrestha, Nutan Agarwal
Diabetes in pregnancy starts affecting the foetus even in the pre-conception period. The complications encountered in third trimester are foetal macrosomia and intrauterine foetal demise; birth of a macrosomic baby further leads to shoulder dystocia, birth trauma, brachial plexus injury. Additionally, pregnancies with overt/pregestational diabetes may be complicated with foetal growth restriction, congenital abnormalities diagnosed in third trimester and foetal hypertrophic obstructive cardiomyopathy. Even minor degrees of hyperglycaemia is associated with adverse pregnancy outcome...
September 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27607406/extracorporeal-membrane-oxygenation-for-treatment-of-acute-inverted-takotsubo-like-cardiomyopathy-from-hemorrhagic-pheochromocytoma-in-late-pregnancy
#17
Cornelis Johannes van Zwet, Andreas Rist, Achim Haeussler, Kirk Graves, Andreas Zollinger, Stephan Blumenthal
We describe the first case of a pregnant woman presenting with an acute inverted takotsubo-like cardiomyopathy caused by a postpartum diagnosed hemorrhagic pheochromocytoma, successfully treated with percutaneous venoarterial extracorporeal membrane oxygenation (va-ECMO). During admission, an emergency cesarean delivery had to be performed. The fetus needed resuscitation for 5 minutes. The mother was successfully resuscitated and treated with percutaneous va-ECMO for 7 days. Despite advances in diagnostic techniques during the past decade, in many cases, pheochromocytoma in pregnancy is still missed...
November 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27604170/evidence-for-troponin-c-tnnc1-as-a-gene-for-autosomal-recessive-restrictive-cardiomyopathy-with-fatal-outcome-in-infancy
#18
Rafal Ploski, Malgorzata Rydzanicz, Tomasz M Ksiazczyk, Maria Franaszczyk, Agnieszka Pollak, Joanna Kosinska, Ewa Michalak, Piotr Stawinski, Lidia Ziolkowska, Zofia T Bilinska, Bozena Werner
Restrictive cardiomyopathy is a rare form of pediatric cardiac disease, for which the known genes include MYH7, TNNT2, TNNI3, ACTC1, and DES. We describe a pediatric proband with fatal restrictive cardiomyopathy associated with septal hypertrophy and compound heterozygosity for TNNC1 mutations (NM_003280: p.A8V [c.C23T] and p.D145E [c.C435A]). This association between restrictive cardiomyopathy and TNNC1 mutations was strengthened by prospective observations on the second pregnancy in the family which revealed, in the presence of the same TNNC1 genotype, prenatally diagnosed hypertrophic cardiomyopathy which evolved into restrictive cardiomyopathy, heart failure and death at the age of 9 months...
September 8, 2016: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/27591063/cryptogenic-postpartum-stroke
#19
Dániel Bereczki, Norbert Szegedi, Zoltán Szakács, István Gubucz, Zsolt May
An estimated 25-40% of ischemic strokes are classified as cryptogenic, which means the cause of the cerebral infarction remains unidentified. One of the potential pathomechanisms - especially among young patients with no cardiovascular risk factors - is paradoxical embolism through a patent foramen ovale. Pregnancy, cesarean delivery and the postpartum period are associated with an increased risk of cerebrovascular events. Factors that may contribute to ischemic strokes during gestation and puerperium include classic cardiovascular risk factors, changes in hemostaseology/hemodynamics, and pregnancy-specific disorders such as pre-eclampsia, eclampsia, postpartum cerebral angiopathy or peripartum cardiomyopathy...
2016: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/27545093/peripartum-cardiomyopathy-a-systematic-literature-review
#20
Anne S Ersbøll, Peter Damm, Finn Gustafsson, Niels G Vejlstrup, Marianne Johansen
Peripartum cardiomyopathy (PPCM) is a rare but potentially fatal disease defined by heart failure towards the end of pregnancy or in the months following delivery. We aim to raise awareness of the condition and give the clinician an overview of current knowledge on the mechanisms of pathophysiology, diagnostics and clinical management MATERIAL AND METHODS: Systematic literature searches were performed in PubMed and Embase up to June 2016. Cohorts of more than 20 women with PPCM conducted after 2000 were selected to report contemporary outcomes and prognostic data...
August 22, 2016: Acta Obstetricia et Gynecologica Scandinavica
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