Perioperative Reverse Takotsubo Cardiomyopathy And Peripartum Dilated Cardiomyopathy With Posterior Reversible Encephalopathy Syndrome: A Two-Case Series And Review Of The Literature

Abstract

Background: Stress-induced (Takotsubo) and peripartum cardiomyopathies are uncommon but potentially fatal causes of acute heart failure in young women. Early recognition remains challenging, especially when presentations overlap with obstetric or surgical emergencies.

Cases: We describe (i) a 28-year-old woman who developed reverse Takotsubo cardiomyopathy with an ejection fraction (EF) of 33 % immediately after emergency ileal resection performed 15 days post-caesarean delivery, and (ii) a 28-year-old primigravida who, following a hypertensive crisis and eclamptic seizures at 33 weeks, manifested severe dilated cardiomyopathy (EF 20 %) complicated by posterior reversible encephalopathy syndrome (PRES). Both patients showed near-complete functional recovery within one week (EF > 60 %).

Conclusion: The cases illustrate distinct stress-triggered myocardial phenotypes on the obstetric–surgical continuum and emphasise the value of early echocardiography, guideline-directed heart-failure therapy, and multidisciplinary care.