Key result
Medical therapy resulted in the normalization of left ventricular ejection fraction from 39% to 60% within four weeks in a postpartum patient with reverse Takotsubo syndrome.
Case Report (n=1)
Reverse Takotsubo syndrome is a rare but reversible cause of early postpartum heart failure that responds well to standard heart failure therapy.
Reverse TTS after postpartum sulprostone may mimic peripartum cardiomyopathy; this case leaves open questions of causality and prevalence.
Predominant causes for newly diagnosed postpartum heart failure are preeclampsia and peripartum cardiomyopathy. Being an anatomical variant of Takotsubo syndrome (TTS) reverse TTS in this period is rare. We present a 36 year old patient, who had delivered triplets by cesarean section. Because of postpartum bleeding she was administered sulprostone. Later she was transferred to the Intensive Care Unit with sudden development of dyspnea, tachypnea and tachycardia. Clinical symptoms, laboratory findings and chest radiograph showed signs of acute heart failure. Transthoracic echocardiography (TTE) revealed reverse TTS with moderately reduced left ventricular ejection fraction (LVEF 39%). The patient stabilized with loop diuretic, angiotensine-converting enzyme inhibitors and beta-blockade. Breast-feeding was discouraged and bromocriptine administered. Left ventricular function normalized (LVEF 60%) within four weeks. TTS should be considered in patients with early postpartum development of heart failure. Rapid cardiac recompensation after the start of adequate therapy and complete resolution of clinical symptoms and TTE findings are typical for postpartum TTS.
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Kilian et al. (2018) conducted a case report in Reverse Takotsubo Syndrome / Postpartum Heart Failure (n=1). Medical therapy (loop diuretic, ACE inhibitors, beta-blockade, bromocriptine) was evaluated on Left ventricular ejection fraction (LVEF) normalization. Medical therapy resulted in the normalization of left ventricular ejection fraction from 39% to 60% within four weeks in a postpartum patient with reverse Takotsubo syndrome.
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