Peri-partum cardiomyopathy in a pregnant woman at term revealed by acute pulmonary edema: what to do in front this catastrophic situation?

Peripartum Cardiomyopathy is insufficient congestive heart occurring in the last month of pregnancy and 5  months after delivery, in the absence of preexisting heart disease and identified etiology. This heart disease is associated with echocardiography systolic dysfunction and left ventricular dilatation. Its incidence ranges from 1/3000 to 1/15000, depending on the region, including much higher in some African countries, it particularlyconcern women over 30 years, multiparous and multiple pregnancies. The pathogenesis remains unclear, the prognosis is closely related to the complete recovery of cardiac function. We report through the clinical case of a woman aged 33 years admitted to the ICU for acute pulmonary edema of sudden onset of a term pregnancy and what to do before this critical situationKey words: Peri-partum, cardiomyopathy, acute pulmonary edem

Peri-partum cardiomyopathy in a pregnant woman at term revealed by acute pulmonary edema: what to do in front this catastrophic situation? Case report Open Access

Abstract Peripartum Cardiomyopathy is insufficient congestive heart occurring in the last month of pregnancy and 5 months after delivery, in the absence of preexisting heart disease and identified etiology. This heart disease is associated with echocardiography systolic dysfunction and left ventricular dilatation. Its incidence ranges from 1/3000 to 1/15000, depending on the region, including much higher in some African countries, it particularly concern women over 30 years, multiparous and multiple pregnancies. The pathogenesis remains unclear, the prognosis is closely related to the complete recovery of cardiac function. We report through the clinical case of a woman aged 33 years admitted to the ICU for acute pulmonary edema of sudden onset of a term pregnancy and what to do before this critical situatio

Upper gastrointestinal bleeding after open heart surgery

Objective: The occurrence of digestive complications especially upper gastrointestinal bleeding (UGIB) has increased after cardiac surgery. The aim of this study was to determine the incidence of UGIB and identify the independent risk factors. Materials and Methods: We retrospectively analyzed data of 1077 patients undergoing cardiopulmonary bypass (CPB) from 1994 to 2012 The group of patients with UGIB (n 1 = 20) was compared with the population group (n 2 = 1057). Demographic characteristics, therapeutic management, endoscopic findings, and outcomes were analyzed. Through a regression analysis we identified independent risk factors of UGIB. Results: The mean age of the group n 1 was 58.2 ± 12.4 years and 50.18 ± 13.5 years in the group n 2. UGIB occurred about 13 ± 5.5 days after cardiac surgery. Gastroduodenal ulcer was the most common etiology of hemorrhage (n = 13, 65%). Renal insufficiency, previous gastric ulcer, increased lactate concentration during CPB, prolonged mechanical ventilation, use of vasopressor drug and pulmonary infection was likely contributing factors in UGIB. Conclusion: UGIB following open cardiac surgery is most frequently secondary to gastroduodenal ulceration. Many determinant factors of bleeding are incriminated. Surgeons must be aware of these factors to avoid fatal complications