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Reversion of Severe Mitral Insufficiency in Peripartum Cardiomyopathy Using Levosimendan

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dc.creatorEstrada, Victor H. Nietospa
dc.creatorFranco, Daniel L. Molanospa
dc.creatorMoreno, Albert Alexander Valenciaspa
dc.creatorGambasica, Jose A. Rojasspa
dc.creatorBornacelli, Yamil E. Jallerspa
dc.creatorDel Valle, Anacaona Martinezspa
dc.date.accessioned2020-06-11T13:22:02Z
dc.date.available2020-06-11T13:22:02Z
dc.date.created2015spa
dc.description.abstractIdiopathic peripartum cardiomyopathy presenting with heart failure is a true diagnostic and treatment challenge. Goal oriented clinical management aims at the relapse of left ventricular systolic dysfunction. A 35-year-old patient on her 12th day post-delivery presents progressive signs of heart failure. Transthoracic echocardiography showed severe mitral insufficiency, mild left ventricular dysfunction, mild tricuspid insufficiency, severe pulmonary hypertension, and right atrial enlargement. With wet and cold heart failure signs, the patient was a candidate for inodilator cardiovascular support and volume depletion therapy. As the patient presented a persistent tachycardia at rest, levosimendan was chosen over dobutamine. Levosimendan was administered at a dose of 0.2 g/kg/min during a period of 24 hours. After inodilator therapy, the patient's signs and symptoms of heart failure began to decrease, showing improvement of dyspnea, mitral murmur grade went from IV/IV to II/IV, filling pressures and systemic and pulmonary resistance indexes decreased, arterial blood gases improved, and an echocardiography performed 72 h later showed non-dilated cardiomyopathy, mild cardiac contractile dysfunction, mild mitral insufficiency, type I diastolic dysfunction and improvement of pulmonary hypertension. Cardiovascular function in peripartum cardiomyopathy tends to go back to normality in 23-41% of the cases, but in a large group of patients, severe ventricle dysfunction remains months after initial symptoms. This article describes the diagnostic process of a patient with peripartum cardiomyopathy and a successful reversion of a severe case of mitral insufficiency using levosimendan as a new therapeutic strategy in this clinical context.eng
dc.format.mimetypeapplication/pdf
dc.identifier.doihttps://doi.org/10.14740/jocmr2323w
dc.identifier.urihttps://repository.urosario.edu.co/handle/10336/24997
dc.language.isoeng
dc.publisherJournal of Clinical Medicine Researchspa
dc.relation.citationEndPage1001
dc.relation.citationIssueNo. 12
dc.relation.citationStartPage998
dc.relation.citationTitleJournal of Clinical Medicine Research
dc.relation.citationVolumeVol. 7
dc.relation.ispartofJournal of Clinical Medicine Research, ISSN: , Vol.7, No.12 (2015); pp. 998-1001spa
dc.relation.urihttps://www.jocmr.org/index.php/JOCMR/article/download/2323/1314spa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto Completo)spa
dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subject.keywordCardiorespiratory Medicine and Haematologyspa
dc.subject.keywordMedical and Health Sciencesspa
dc.titleReversion of Severe Mitral Insufficiency in Peripartum Cardiomyopathy Using Levosimendanspa
dc.typearticleeng
dc.type.hasVersioninfo:eu-repo/semantics/publishedVersion
dc.type.spaArtículospa
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