A Case of Fatal Acute Pulmonary Edema due to Unrecognized Peripartum Cardiomyopathy

周產期心肌病變合併致命的急性肺水腫－病例報告

傅瑞英(Jui-Ying Fu) ； 高國晉(Kuo-Chin Kao) ； 胡漢忠(Han-Chung Hu) ； 謝孟哲(Meng-Jer Hsieh) ； 黃崇旂(Chung-Chi Huang)

《胸腔醫學》 22卷1期 (2007/02) Pp. 66-72

https://doi.org/10.29806/TM.200702.0010

摘要

周產期心肌病變是孕婦或產後心臟衰竭的罕見原因之一。它發生於懷孕的最後一個月以及產後的前五個月。診斷最主要是要排除已知原因的心肌病變以及吻合心臟超音波的診斷條件。致病基轉仍不明。我們報告一病例，在產後一天發生急性肺水腫合併呼吸衰竭。雖然病患併有使用β-adrenergic agonist安胎的病史，但經由完整的心臟超音波檢查以及排除其他原因的心肌病變後，確立診斷為周產期心肌病變。產後急性肺水腫可以進展至致命的呼吸衰竭，所以臨床醫師的如果能及早覺察，早期給予積極治療，應該能改善此類病人的預後結果。

關鍵字

周產期心肌病變 ； 急性肺水腫

並列摘要

Peripartum cardiomyopathy is a rare form of heart failure that occurs during the 6 months from the last month of pregnancy to the first 5 months after delivery. The diagnosis is made by strict clinical and echocardiography criteria. It can result in a lethal outcome; the reported mortality rate ranges from 20% to 85%. The causes of death are worsening heart failure, arrhythmia, and thromboembolic events, and over half the patients die suddenly. But the complications are often reversible if recognized promptly and treated adequately, so we should keep the differential diagnosis in mind if heart failure signs develop in a patient during the peripartum period. Herein, we describe the case of a patient diagnosed as peripartum cardiomyopathy complicated with fatal acute pulmonary edema within 1 day after delivery, who improved rapidly after optimal management of heart failure.

並列關鍵字

peripartum cardiomyopathy ； acute pulmonary edema