Key result
COVID-19 infection presents with concurrent hypertensive emergency and HFpEF in a postpartum patient with preeclampsia.
Why the study?
Understanding of COVID-19 in pregnant and postpartum women, especially with superimposed preeclampsia and heart failure with preserved ejection fraction, is rapidly evolving.
Case Report (n=1)
A high index of suspicion for both COVID-19 and cardiovascular complications is critical in postpartum patients presenting with cardiopulmonary symptoms.
May prompt COVID-19 evaluation in postpartum preeclampsia with cardiac symptoms; hypothesis-generating for concurrent HFpEF.
Our understanding of COVID-19 in pregnant and postpartum women is rapidly evolving. We present a case from March 2020 of a 25-year-old G2P2002 whose delivery was complicated by preeclampsia with severe features who presented to the emergency department 9 days after cesarean delivery with chest tightness and dyspnea on exertion. On presentation she had severe hypertension, pulmonary edema, elevated brain natriuretic peptide, and high-sensitivity troponin-I, suggesting a diagnosis of hypertensive emergency leading to heart failure with a preserved ejection fraction resulting in pulmonary edema and abnormal cardiac screening tests. However, bilateral opacities were seen on a computed tomography of the chest, and COVID-19 testing was positive. A high index of suspicion for both COVID-19 and cardiovascular complications are critical for optimal patient outcomes and protection of health care workers.
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Sinkey et al. (2020) conducted a case report in Heart failure with preserved ejection fraction, preeclampsia, and COVID-19 (n=1). COVID-19 infection was evaluated. COVID-19 infection in a 25-year-old postpartum patient with preeclampsia presented concurrently with hypertensive emergency and heart failure with preserved ejection fraction.
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