Careful management of intravascular volume and strict blood pressure control are essential to prevent acute pulmonary edema in post-MI parturients with diastolic dysfunction during the immediate postpartum period.
Highlights risk of acute pulmonary edema in post-MI parturients postpartum; single case leaves open optimal prevention strategies.
We report a case of 29-year-old, morbidly obese, diabetic primigravida who had undergone previously primary percutaneous coronary intervention with stent placement for an inferior wall myocardial infarction at 10 weeks of gestation. She remained asymptomatic with medication during the remainder of her pregnancy, but preoperative echocardiography revealed left ventricular dilation and a restrictive diastolic dysfunction with a preserved ejection fraction (46%). She developed acute pulmonary edema associated with hypertension after an elective Cesarean delivery under continuous epidural anesthesia despite the meticulous restriction of fluid.
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Jung et al. (2010) studied this question.
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