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Cardiogenic shock in women: From risk factors to therapy.

Kardiol Pol

December 2024

Department of Cardiology, Rigshospitalet, Copenhagen, Denmark.

Cardiogenic shock (CS) in women is a serious cardiovascular (CV) event associated with a high mortality rate. Non-ischemic etiologies are the most common etiologies in women, such as stress-induced cardiomyopathy, peripartum/postpartum cardiomyopathy, heart failure-related CS, or CS due to myocarditis or valvular heart disease. Although not being the most common etiology in women, acute myocardial infarction is still an important one.

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Peripartum cardiomyopathy (PPCM) is a rare, but serious condition, with a non-negligible risk of adverse events. Several risk factors for PPCM have been individuated over the years, including Afro-American ethnicity, preeclampsia, advanced maternal age, genetic predisposition, multiparity, twin pregnancy, obesity, smoking and diabetes. However, PPCM pathophysiology is still poorly understood, thus making it challenging to develop disease specific therapies.

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Preemptive Use of a Left Microaxial Flow Pump in Peripartum Cardiomyopathy.

JACC Case Rep

December 2024

Division of Cardiology, Baylor Scott and White Health-Temple, Temple, Texas, USA.

Management of peripartum cardiomyopathy and cardiogenic shock often presents a significant clinical challenge. These patients are frequently best served at a specialized center with access to cardiac anesthesia, maternal-fetal medicine, and cardiac intensivists. Planning for delivery involves a plan for anesthesia and management of hemodynamic changes during the postoperative period.

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Peripartum cardiomyopathy is an idiopathic and nonischemic systolic dysfunction with onset toward the end of pregnancy and up to 5 months postpartum. Its clinical phenotype overlaps with pregnancy-associated cardiomyopathy rendering both a continuum of the same disease. Incidence varies geographically and is highest in areas where risk factors are prevalent.

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A case of peripartum cardiomyopathy in dichorionic diamniotic twin pregnancy.

Arch Clin Cases

December 2024

Department of Obstetrics and Gynaecology, Ipswich Hospital, East Suffolk and North Essex Foundation NHS Trust, Suffolk, UK.

Peripartum cardiomyopathy (PPCM) is an uncommon life-threatening condition that is characterized by heart failure with reduced ejection fraction during late pregnancy or within 5 months of postpartum in the absence of other causes of heart failure. Despite advances in managing PPCM, the pathophysiology of it is still poorly understood. This article reviews the diagnostic challenges and management of PPCM, specifically highlighting a rare presentation of PPCM characterized by oxygen desaturation alone.

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