Peripartum cardiomyopathy and clinical masks of severe preeclampsia: Issues of differential diagnosis and management tactics
Background. Noncoronary heart diseases remain one of the least studied cardiologic problems, including those in pregnant women. The introduction of highly informative noninvasive diagnostic techniques, including echocardiography into clinical practice, could identify special nosological entities in a group of noncoronary diseases of the myocardium (cardiomyopathies). Description. The paper presents a clinical case of peripartum cardiomyopathy (PPCM) in a 39-year-old pregnant woman and that of respiratory failure in a 29-year-old pregnant woman with severe preeclampsia that required a thorough diagnostic and differential diagnostic search for PPCM. It considers the pathogenesis of PPCM, the features and community of vasculopathy in PPCM and preeclampsia, diagnosis and differential diagnosis, the prediction of adverse outcomes, and therapy characteristics. Conclusion. The timely diagnosis, differential diagnosis, consideration of all the classical clinical manifestations of the disease, and correct and pathogenetically grounded treatment may result in rapid relief of the signs of heart failure and pulmonary edema and in complete recovery of systolic function of the heart.