{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:05Z","timestamp":1753876145904,"version":"3.41.2"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T00:00:00Z","timestamp":1663891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Peripartum cardiomyopathy (PPCM) usually affects women in the last month of pregnancy or in the first months following delivery and typically presents with signs and symptoms of heart failure (HF), although catastrophic presentations may be the initial manifestation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 36-year-old woman reported intense fatigue that began after delivery. Three months following delivery, she suffered a cardiac arrest at home, in shockable rhythm, with a total estimated time of 70\u2005min before return of spontaneous circulation. Electrocardiogram presented diffuse ST-segment depression and transthoracic echocardiography showed severe left-ventricle (LV) dysfunction with global hypokinesis. In the catheterization laboratory, she underwent a triple rule out (no aortic, coronary, or pulmonary vascular disease); ventriculography was not suggestive of Takotsubo syndrome. She was transferred to the cardiac intensive care unit, under invasive mechanical ventilation and vasopressor support. A presumptive diagnosis of PPCM was made and bromocriptine and heparin were started. In three days, she was weaned from haemodynamic support and extubated, with good neurologic outcome. Cardiac magnetic resonance showed no signs of inflammation or fibrosis. Cardiomyopathy genetic test was negative. PPCM diagnosis was assumed, HF therapy was introduced and a cardioverter-defibrillator was implanted. At 2.5 months follow up, she presented HF NYHA Class II and recovered LV function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>We present a case of a woman, three months after delivery, who developed a catastrophic manifestation of PPCM. This case raises awareness about atypical presentations of PPCM, whose diagnosis should be considered in the appropriate clinical context, but ultimately, remains a diagnosis of exclusion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac395","type":"journal-article","created":{"date-parts":[[2022,9,23]],"date-time":"2022-09-23T19:34:24Z","timestamp":1663961664000},"source":"Crossref","is-referenced-by-count":1,"title":["Catastrophic presentation of peripartum cardiomyopathy: a case report of a challenging diagnosis"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6339-659X","authenticated-orcid":false,"given":"Mariana Ribeiro","family":"Silva","sequence":"first","affiliation":[{"name":"Cardiology Department, Centro Hospitalar de Vila Nova de Gaia\/Espinho , Porto , Portugal"}]},{"given":"Gualter Santos","family":"Silva","sequence":"additional","affiliation":[{"name":"Cardiology Department, Centro Hospitalar de Vila Nova de Gaia\/Espinho , Porto , Portugal"}]},{"given":"Daniel","family":"Caeiro","sequence":"additional","affiliation":[{"name":"Cardiology Department, Centro Hospitalar de Vila Nova de Gaia\/Espinho , Porto , Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2306-8393","authenticated-orcid":false,"given":"Ricardo","family":"Fontes-Carvalho","sequence":"additional","affiliation":[{"name":"Cardiology Department, Centro Hospitalar de Vila Nova de Gaia\/Espinho , Porto , Portugal"},{"name":"Departamento de Cirurgia e Fisiologia, Faculdade de Medicina da Universidade do Porto , Porto , Portugal"}]}],"member":"286","published-online":{"date-parts":[[2022,9,23]]},"reference":[{"key":"2022101115464509900_ytac395-B1","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1002\/ejhf.1493","article-title":"Pathophysiology, diagnosis and management of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Study Group on peripartum cardiomyopathy","volume":"21","author":"Bauersachs","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2022101115464509900_ytac395-B2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.jacc.2019.11.014","article-title":"Peripartum cardiomyopathy: JACC state-of-the-art review","volume":"75","author":"Davis","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2022101115464509900_ytac395-B3","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1038\/nature11040","article-title":"Cardiac angiogenic imbalance leads to peripartum cardiomyopathy","volume":"485","author":"Patten","year":"2012","journal-title":"Nature"},{"key":"2022101115464509900_ytac395-B4","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1038\/nrcardio.2014.37","article-title":"Pathophysiology and epidemiology of peripartum cardiomyopathy","volume":"11","author":"Hilfiker-Kleiner","year":"2014","journal-title":"Nat Rev Cardiol"},{"key":"2022101115464509900_ytac395-B5","doi-asserted-by":"crossref","first-page":"e004134","DOI":"10.1161\/CIRCHEARTFAILURE.117.004134","article-title":"Incidence, risk factors, and clinical characteristics of peripartum cardiomyopathy in South Korea","volume":"11","author":"Lee","year":"2018","journal-title":"Circ Heart Fail"},{"key":"2022101115464509900_ytac395-B6","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1097\/AOG.0b013e31826e46a1","article-title":"Peripartum cardiomyopathy: population-based birth prevalence and 7-year mortality","volume":"120","author":"Harper","year":"2012","journal-title":"Obstet Gynecol"},{"key":"2022101115464509900_ytac395-B7","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1001\/jama.283.9.1183","article-title":"Peripartum cardiomyopathy. 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