TITLE:
Peripartum Cardiomyopathy: Epidemiological, Clinical, Para-Clinical and Therapeutic Aspects at the Tombouctou Hospital
AUTHORS:
Souleymane Mariko, Massama Konaté, Samba Sidibé, Karamoko Kantako, Charles Dara, Djibril Kassogué, Nouhoum Diallo, Coumba A. Thiam, Aniessa Kodio, Mariam Sako, Abdoul Karim Sacko, Mamadou Diakité, Souleymane Coulibaly, Ilo Bella Diall, Ichaka Menta
KEYWORDS:
Heart Failure, Cardiomyopathy, Peripartum, Treatment
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.11 No.3,
March
23,
2021
ABSTRACT: Introduction: Peripartum cardiomyopathy (PPCM) is a heart failure whose etiology is still unknown. The aim of work was to study peripartum cardiomyopathy in its epidemiological, clinical, paraclinical and therapeutic aspects at the Tombouctou hospital. Methods: This is a descriptive cross-sectional study carried out in the Medicine Department of the Timbuktu hospital from January 1 to December 31, 2019. It concerned patients who presented heart failure between the 8th month of pregnancy and the first 5 months postpartum. Results: During the study,23 patients were collected. Average age of the patients was 23.50 ± 3.50 years with extremes of 16 and 34 years. Incidence of Peripartum cardiomyopathy (PPCM) was 1/345 pregnancies. Average parity was 3.20 with extremes of 1 and 8. Symptoms appeared at postpartum with 87% of cases. A significant delay in diagnosis was observed. Global heart failure was the mode of decompensation with 70%. Electrocardiographic signs were mainly sinus tachycardia (87%) and left ventricular hypertrophy (83%). Cardiac ultrasound showed in all cases dilated cardiomyopathy and it was associated with thrombus in left ventricle cavity for three cases. Left ventricular ejection fraction was severely impaired in 70% of cases. Pulmonary hypertension was significant in 52%. Most commonly drugs we used in our series at acute stage were duretics: furosemide 100% and spironolactone 70% (100% and 70%) and ACE inhibitors (90%). Beta-blockers (bisoprolol and carvedilol) were used in 15 patients. Bromocriptine (prolactin inhibitor) was used for 2 patients. Conclusion: Peripartum cardiomyopathy is a serious cardiac complication of pregnancy of unknown cause, common in the African population.