An 18-months follow up of a Postpartum cardiomyopathy Case

To report a case of peripartum cardiomyopathy occurring one week postpartum, detailing the patient’s response to heart failure therapy and adjunctive bromocriptine treatment. We present a case study incorporating clinical and laboratory data. Relevant current literature was reviewed and summarized regarding peripartum cardiomyopathy and the use of bromocriptine as part of medical management in this patient population. A 35-year-old woman presented one week postpartum with dyspnea and lower limb edema. Clinically and radiographically, she demonstrated signs of volume overload. Laboratory testing revealed markedly elevated NT-proBNP levels, and echocardiography showed biventricular dysfunction with a severely reduced LVEF of approximately 22%. Peripartum cardiomyopathy was diagnosed after excluding differential diagnoses, including coronary artery disease. Management included symptomatic treatment for acute heart failure with intravenous diuretics and guideline-directed heart failure therapy. Off-label bromocriptine (a prolactin secretion antagonist) was added, resulting in favorable clinical evolution. After six weeks of therapy, LVEF improved to 40%, with further recovery to 49% at four-month follow-up following discontinuation of bromocriptine. In peripartum cardiomyopathy, the addition of bromocriptine to guideline-directed heart failure therapy may favorably influence disease progression and improve prognosis. • A case of peripartum cardiomyopathy occurring one week postpartum detailing the patient’s response to heart failure therapy and adjunctive bromocriptine treatment. • An 18-months follow up on guideline-directed heart failure therapy including bromocriptine treatment showed a notable improvement clinically and on echographically. • The addition of bromocriptine to guideline-directed heart failure therapy may favorably influence disease progression and improve prognosis.