Key result
A 14-year-old patient with familial dilated cardiomyopathy successfully delivered a healthy infant and was safely managed postpartum with a wearable cardiac defibrillator for severe left ventricular dysfunction.
Why the study?
Women with pre-existing familial cardiomyopathy face increased morbidity and mortality during pregnancy, but consensus on management is lacking due to the condition's rarity.
Case Report (n=1)
This case demonstrates the successful multidisciplinary management and novel use of a wearable cardiac defibrillator in a pregnant 14-year-old with familial dilated cardiomyopathy and severely reduced ejection fraction.
Answers are grounded in this paper and cite their sources.
May inform individualized care in rare pregnant adolescents with severe cardiomyopathy; leaves open wearable defibrillator efficacy without prospective data.
BACKGROUND: Women with pre-existing forms of familial cardiomyopathy are at increased risk for morbidity and mortality due to hemodynamic changes of pregnancy. There is a lack of consensus about the management and care for these patients given the rarity of this condition. This case represents possibly the youngest pregnant familial dilated cardiomyopathy patient to deliver and the youngest patient to be fitted for a wearable cardiac defibrillator in the postpartum period. CASE PRESENTATION: A 14-year-old gravida 1 with familial dilated cardiomyopathy presented late for prenatal care at 38 weeks, which precluded typical care plans including baseline and serial echocardiograms, medication management, and routine prenatal care. An echocardiogram showed severely decreased left ventricular systolic function compared to studies from one year prior. Three days later the patient presented in labor and had a spontaneous vaginal delivery complicated by postpartum hemorrhage. Her postpartum course was notable for persistence of decreased cardiac function testing and placement of a wearable cardiac defibrillator for prevention against life threatening arrhythmias. CONCLUSION: This case report adds to the literature on pregnancy complicated by familial dilated cardiomyopathy and describes management best practices and considerations during the antepartum, intrapartum, and postpartum periods.
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George et al. (2022) conducted a case report in Familial dilated cardiomyopathy in pregnancy (n=1). Wearable cardiac defibrillator and multidisciplinary management was evaluated. A 14-year-old patient with familial dilated cardiomyopathy successfully delivered a healthy infant and was safely managed postpartum with a wearable cardiac defibrillator for severe left ventricular dysfunction.
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