Postpartum acute myocardial dysfunction assessed by multimodality imaging: Case report.
DOI:
https://doi.org/10.37615/retic.v9n2a12Keywords:
postpartum period, takotsubo cardiomyopathy, echocardiography, cardiac magnetic resonance imagingAbstract
Acute myocardial dysfunction in the postpartum period poses a diagnostic challenge as it may be caused by potentially serious conditions, including acute coronary syndrome, spontaneous coronary artery dissection, coronary vasospasm, peripartum cardiomyopathy and takotsubo syndrome. We report the case of a postpartum woman after urgent cesarean section who developed chest pain, hypertensive emergency, electrocardiographic abnormalities and elevated cardiac biomarkers. Initial echocardiography showed midventricular regional wall motion abnormalities with early partial improvement, suggesting reversible myocardial dysfunction. Several days later, she was readmitted with heart failure, hypertension, progressive dyspnea and subsegmental pulmonary embolism with bilateral pleural effusion. Persistent cardiac wall motion abnormalities prompted a comprehensive etiological work-up. Coronary angiography ruled out obstructive coronary artery disease, and cardiac magnetic resonance imaging demonstrated findings consistent with midventricular stress cardiomyopathy. This case highlights the value of multimodal cardiac imaging to integrate clinical findings, exclude alternative diagnoses, and establish an accurate diagnosis in a highly complex clinical setting.
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Copyright (c) 2026 Angelo Barletta Esteller, Ana Fernández Vega, María Luisa Salto Camacho , María Jóse Calero Rueda
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