Peripartum cardiomyopathy: a rare complication in a teenage pregnancy

The aim of this case report was to present a rare case of peripartum cardiomyopathy (PPCM) in an adolescent primigravida, and discuss its presentation and successful management. PPCM is a relatively rare yet life threatening cardiac complication of pregnancy. It often remains undiagnosed as its symptoms may simulate the physiological symptoms of pregnancy and peripartum period. An early diagnosis is crucial for improving survival. We herein report an unusual case of PPCM in an young and otherwise healthy primigravida. A 19-year-old primigravida presented at 33 weeks of gestation with, severe pre-eclampsia with dyspnea, cough and discomfort in the chest. Based on clinical findings and ECG, the echocardiography was done, and a definitive diagnosis of PPCM was made. The patient was managed for heart failure and preeclampsia by a multidisciplinary team. Emergency cesarean was done for obstetric indication and patient was managed conservatively in intensive care unit. Patient improved clinically and was discharged at day 10. Peripartum cardiomyopathy though typically associates with advanced maternal age can occur in very young women as well. A high index of suspicion for PPCM is recommended on a background of `severe preeclampsia with breathlessness. Timely echocardiography for diagnosis, and a multidisciplinary team approach are a key to successful management. Clinical significance of the study was to shed new light on the unusual presentation of PPCM and to contribute to the existing knowledge of PPCM.