Sonila BELE, Abanana BANUSHI, Teuta BARE
Perinatal Journal - 2026;34(2):344-348
Peripartum Cardiomyopathy (PPCM) is a rare but potentially life-threatening cause of heart failure occurring toward the end of pregnancy or in the months following delivery. Its diagnosis may be challenging, particularly in patients with complex obstetric and oncologic histories. We report the case of a 38-year-old primiparous woman with a twin pregnancy who developed secondary postpartum hemorrhage requiring hysterectomy. On postoperative day five, she presented with acute heart failure manifested by severe dyspnea, orthopnea, tachycardia, pulmonary edema, and reduced left ventricular ejection fraction (40%). Her history was significant for prior chemotherapy and radiotherapy for Hodgkin and non-Hodgkin lymphoma. Imaging excluded pulmonary embolism and infection. Transthoracic echocardiography revealed dilated cardiomyopathy with systolic dysfunction. She was treated with guideline-directed heart failure therapy, including beta-blockers, diuretics, ACE inhibitors (later switched to sacubitril/valsartan), bromocriptine, and anticoagulation. Progressive improvement in cardiac function was observed during follow-up, with left ventricular ejection fraction improving to 61% at 36 months. This case highlights the diagnostic complexity of acute heart failure in the postpartum period, particularly in patients with prior exposure to potentially cardiotoxic oncologic therapies. Early recognition and multidisciplinary management are crucial for favorable outcomes.
