Pregnancy may provoke life-threatening peripartum cardiomyopathy in women with a history of cardiotoxic chemotherapy and radiation for breast cancer.
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Case suggests conservative management may suffice for chemotherapy-related peripartum cardiomyopathy; leaves open need for prospective validation.
Aim: To report on a pregnant woman with peripartum cardiomyopathy 7 years after combination chemotherapy with doxorubicine and radiation of cancer of the left breast. Case: A 35-year old primigravida who was treated 7 years earlier with cancer of the left breast (ympT1c, ypN0, cM0), according to a neoadjuvant study protocol (GeparTrio), was transferred to our unit due to HELLP syndome at 35+5 weeks. Symptoms of cardiopulmonary decompensation occurred shortly after cesarean delivery of a healthy newborn. The patient was admitted to cardiac intensive care and treated with oxygen, diuretics and ACE inhibitors. Maternal left ventricular ejection fraction recovered within a few weeks without any surgical interventions and remained stable within 1 year of follow-up. Conclusion: The association between radical primary treatment of the left breast and life-threatening cardiac disease could possibly be provoked by pregnancy.
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Kyvernitakis et al. (2013) studied this question.
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