High intracardiac clot burden in a young mother with peripartum cardiomyopathy in Uganda

Juliet Nabbaale, Emmy Okello, Karen Sliwa, Annette Nakimuli

Abstract

Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy presenting with a reduction in left ventricular systolic function towards the end of pregnancy or in the months after delivery. It is a life-threatening condition with a substantial mortality rate ranging from six to 25%, commonly due to heart failure or sudden cardiac death. Pregnancy is a prothrombotic state. Due to poor systolic function, women with PPCM are prone to intracardiac thrombi and a high risk of thromboembolic events. Early diagnosis with echocardiography and treatment plays a critical role. We describe a case of a woman with PPCM and biventricular thrombi, with the aim of creating awareness for early echocardiographic screening for thrombi and appropriate implementation of care.