Abstract
Introduction:
Peripartum Cardiomyopathy (PPCM) is a rare form of heart failure occurring during late pregnancy or within five months postpartum, its etiology remaining elusive. While typically characterized by left ventricular dysfunction, it may present with intracardiac thrombi, raising the risk of systemic embolization. Here, we report an unusual case of PPCM featuring biventricular intracardiac thrombi, highlighting the importance of a thorough investigation for potential underlying causes.
Case presentation:
This is a case of a black African, multiparous woman aged 44 years with an unremarkable past medical history, who presented with symptoms suggestive of acute heart failure five months after her last delivery. A 2D Transthoracic Echocardiography showed multiple biventricular intracardiac thrombi, a rare complication of PPCM without a systemic embolic event. Further, laboratory tests for evidence of a hypercoagulable state came out negative. Treatment involved a combination of acute heart failure, and anticoagulation followed by optimal medical therapy for chronic heart failure, resulting in improved symptoms for heart failure, cardiac function, and significant thrombi resolution after 8 weeks.
Conclusion
Multiple biventricular intracardiac thrombi are uncommon finding in Peripartum Cardiomyopathy (PPCM), emphasizing the need for vigilant diagnosis and management. Despite the absence of identifiable secondary causes, prompt management of acute heart failure and anticoagulation led to significant thrombi resolution and improved cardiac function. This case highlighted the significance of the complex management of PPCM, in an individualized manner.