Successful Management in a Case of Dilated Cardiomyopathy in Pregnancy

Abstract

Dilated cardiomyopathy (DCM) is a rare but high-risk condition encountered in pregnancy, associated with significant maternal morbidity and mortality. It is characterized by ventricular dilatation and impaired systolic function, often in the absence of coronary, valvular, or congenital heart disease. Pregnancy superimposed on pre-existing DCM poses unique challenges due to the hemodynamic burden of gestation and the potential for rapid cardiac decompensation.

We present the case of a 35-year-old gravida 2, para 1 woman with a known history of coronary artery disease and reduced left ventricular ejection fraction (EF 38%), who was successfully managed throughout pregnancy with a multidisciplinary approach. She underwent elective caesarean section at 35 weeks under combined spinal-epidural anesthesia, delivering a healthy male neonate. Although she experienced transient postoperative pulmonary edema and further decline in EF to 32%, she stabilized with medical management and was discharged on day 6.

This case highlights the importance of vigilant antenatal surveillance, early involvement of a multidisciplinary team, and timely intervention in achieving favorable maternal and neonatal outcomes in patients with dilated cardiomyopathy.