Author(s): Melo,Maria Adélia Medeiros e ; Carvalho,Jordão Sousa ; Feitosa,Francisco Edson de Lucena ; Araujo Júnior,Edward ; Peixoto,Alberto Borges ; Carvalho,Francisco Herlânio Costa ; Carvalho,Regina Coeli Marques
Date: 2016
Origin: Oasisbr
Subject(s): peripartum cardiomyopathy; congestive heart failure; dopamine agonists; pregnancy outcome
Abstract Pathophysiological mechanisms of peripartum cardiomyopathy are not yet completely defined, although there is a strong association with various factors that are already known, including pre-eclampsia. Peripartum cardiomyopathy treatment follows the same recommendations as heart failure with systolic dysfunction. Clinical and experimental studies suggest that products of prolactin degradation can induce this cardiomyopathy. The pharmacological suppression of prolactin production by D2 dopamine receptor agonists bromocriptine and cabergoline has demonstrated satisfactory results in the therapeutic response to the treatment. Here we present a case of an adolescent patient in her first gestation with peripartum cardiomyopathy that evolved to the normalized left ventricular function after cabergoline administration, which was used as an adjuvant in cardiac dysfunction treatment. Subsequently, despite a short interval between pregnancies, the patient exhibited satisfactory progress throughout the entire gestation or puerperium in a new pregnancy without any cardiac alterations. Dopamine agonists that are orally used and are affordable in most tertiary centers, particularly in developing countries, should be considered when treating peripartum cardiomyopathy cases.
