Pregnancy-Associated Cardiomyopathy (PACM) in a Preeclamptic Woman with Twin Pregnancy: A Case Report

Peripartum cardiomyopathy (PPCM) is an uncommon disease, a dilated cardiomyopathy type occurs in the fi nal gestation month and within 5 months after giving birth. A related term, pregnancy-associated cardiomyopathy (PACM) occurs before it. The morbidity and mortality rates are high. Women with preeclampsia with twin pregnancies are at a markedly elevated risk of developing PACM/PPCM. A 40-year-old multiparous woman with twin pregnancy came to the emergency room at gestational week 20, exhibited cough, dyspnea, full bilateral rales, extremities edema, cardiomegaly, hypertension, proteinuria, and the left ventricular ejection fraction was 26%. She was diagnosed with acute lung edema, PACM, and preeclampsia. The pregnancy was terminated and treated with drug therapy of heart failure. Delay of diagnostic procedures may lead to severe maternal morbidity and infant mortality in this PACM case. It emphasized the need for attention of the risk factors, preeclamptic and twin pregnancy, and may be candidates for monitoring of left ventricular function. Early and appropriate management may prevent irreversible PACM.