Open AccessComplete recovery of fulminant peripartum cardiomyopathy on mechanical circulatory support combined with high‐dose bromocriptine therapy
Author(s) -
Horn Patrick,
Saeed Diyar,
Akhyari Payam,
HilfikerKleiner Denise,
Kelm Malte,
Westenfeld Ralf
Publication year - 2017
Publication title -
esc heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.787
H-Index - 25
ISSN - 2055-5822
DOI - 10.1002/ehf2.12175
Subject(s) - medicine , peripartum cardiomyopathy , cardiogenic shock , heart failure , cardiomyopathy , fulminant , cardiology , circulatory system , afterload , shock (circulatory) , myocardial infarction , hemodynamics
Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy presenting with heart failure due to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of heart failure is found. We report a case of a woman with PPCM who developed a critical cardiogenic shock with repeated cardiopulmonary resuscitation. We show for the first time that mechanical circulatory support combined with high‐dose bromocriptine therapy to suppress systemic prolactin levels may serve as an effective therapeutic option in patients with fulminant PPCM and cardiogenic shock. Myocardial cathepsin D was overexpressed in our patient underscoring a potential role of cathepsin D‐induced cleavage of prolactin in the pathophysiology of PPCM.