Peripartum Cardiomyopathy: The Value of Endomyocardial Biopsy in Diagnosis, Prognostication, and Therapy

AUTOR(ES)

Fuentes, Francisco

RESUMO

We describe the case of a 21-year-old black female who was readmitted postpartum because of increasing exertional dyspnea, orthopnea, pleuritic chest pain, and pedal edema. The patient underwent a successful course of clinical treatment for peripartum cardiomyopathy consisting of a regimen of digoxin, diuretics, captopril, and heparin. The results of an endomyocardial biopsy done at readmission were normal: there was no evidence of inflammation, necrosis, or fibrosis; the endocardium, intramural arterioles, mitochondria, and ultrastructure were normal, as was the amount of glycogen; nuclear chromatin were evenly dispersed; and no antibodies were found. Previous studies have shown that approximately half of patients who suffer from peripartum cardiomyopathy recover, while half develop a more severe form of dilated cardiomyopathy. We venture to speculate that normal endomyocardial biopsy findings during the acute stage of the disease may be predictive of recovery. With more certainty, we propose that histologic findings from material taken during an acute episode can and should guide the course of therapy. (Texas Heart Institute Journal 1988;15:55-58)

Documentos Relacionados

• Pregnancy and peripartum cardiomyopathy: a comparative and prospective study
• Peripartum heart disease: an endomyocardial biopsy study.
• Tenascin expression in endomyocardial biopsy specimens in patients with dilated cardiomyopathy: distribution along margin of fibrotic lesions.
• Endomyocardial biopsy in diagnosis of cardiomyopathies.
• Critical assessment of diagnostic value of endomyocardial biopsy. Assessment of cardiac biopsy.