Full recovery of cardiac function after discontinuing medications in peripartum cardiomyopathy with cardiogenic shock

Abstract

Peripartum cardiomyopathy (PPCM) is a rare idiopathic form of cardiomyopathy. There are no clarified guidelines for managing PPCM patients with critical cardiogenic shock, and when it is best to discontinue medications after full recovery of left ventricular cardiac function has always been a controversial problem. Here, we report a case of a PPCM patient with critical cardiogenic shock. Mechanical circulatory support was employed to help her through the high-risk period, and when she felt asymptomatic, the patient immediately discontinued taking all heart failure medications. Surprisingly, her cardiac function completely recovered during the 22 months of follow-up, and she reported no chest tightness, lower limb edema, or other discomfort in recent follow-up. This case demonstrated that mechanical circulatory support can be used as a safe bridge to conservative drug therapy in PPCM patients with critical cardiogenic shock and that when left ventricular function is fully recovered, drug withdrawal under a doctor’s supervision may be an option for PPCM patients.
(Am J Transl Med 2022. 6(1):25-32).