Integrated medical therapy including heart failure medications, anticoagulation, and antithyroid drugs led to significant clinical improvement in a 30-year-old woman with PPT and PPCM.
Case Report (n=1)
This case highlights the rare coexistence of postpartum thyroiditis and peripartum cardiomyopathy, emphasizing the need for early echocardiography and integrated endocrine-cardiac evaluation in postpartum women with unexplained dyspnea.
Background: Postpartum thyroiditis (PPT) and peripartum cardiomyopathy (PPCM) are important postpartum conditions, but their coexistence is rare. Thyrotoxicosis can increase myocardial stress and precipitate heart failure, particularly in resource-limited settings where diagnosis may be delayed. Case Presentation: A 30-year-old woman presented two months postpartum with thyrotoxic symptoms and was diagnosed with postpartum thyroiditis. Poor adherence to therapy led to progressive dyspnea and edema. Six months postpartum, she re-presented with decompensated heart failure. Chest X-ray showed cardiomegaly. Echocardiography revealed a dilated left ventricle (LVEDD 6.7 cm, LVESD 5.9 cm) with severely reduced systolic function (LVEF ~23%). The right ventricle was dilated with preserved function (TAPSE 1.7 cm). Mild pulmonary hypertension (RVSP 36 mmHg) and multiple right ventricular apical thrombi (n=3) were identified. She was diagnosed with peripartum cardiomyopathy and treated with guideline-directed heart failure therapy, anticoagulation, bromocriptine, and antithyroid medication, with significant clinical improvement. Conclusion: This case highlights the importance of early echocardiography, integrated endocrine–cardiac evaluation, and close postpartum follow-up in women presenting with unexplained dyspnea. Keywords: hyperthyroidism, heart failure, cardiomyopathy, ventricular thrombi, postpartum, rural Uganda
Olive et al. (Fri,) conducted a case report in Postpartum thyroiditis and peripartum cardiomyopathy with right ventricular thrombi (n=1). Guideline-directed heart failure therapy, anticoagulation, bromocriptine, and antithyroid medication was evaluated on Clinical symptom resolution. Integrated medical therapy including heart failure medications, anticoagulation, and antithyroid drugs led to significant clinical improvement in a 30-year-old woman with PPT and PPCM.