{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T10:20:43Z","timestamp":1780568443228,"version":"3.54.1"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T00:00:00Z","timestamp":1707696000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T00:00:00Z","timestamp":1707696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Peripartum cardiomyopathy (PPCM) is a potentially life-threatening pregnancy-related condition characterized by left ventricular dysfunction and heart failure, typically occurring in the peripartum period. Individuals with a history of preeclampsia and hypertension are particularly prone to developing PPCM. Recent research suggests that the condition may be triggered by vascular dysfunction influenced by maternal hormones in the late stages of gestation. The onset of left heart failure results in decreased cardiac output, leading to insufficient perfusion, which in turn, contributes to pulmonary edema and exacerbates tissue hypoxia. This cardiovascular response activates the neurohumoral system, causing peripheral vasoconstriction and elevating both mean capillary filling pressure (MCFP) and central venous pressure (CVP). Early administration of furosemide reduces volume overload due to negative cumulative fluid balance gaining and vasodilation, which increases the velocity of intravascular refilling and causes interstitial edema to resolve. This will decrease interstitial fluid pressure, resulting in decreased mechanical compression to systemic capillary and systemic vein pressure, thus decreasing MCFP and CVP subsequently. Reduced CVP also contributes to increased venous return by decreasing the gradient pressure between MCFP and CVP, resulting in increased cardiac output (CO) and improved tissue oxygenation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case<\/jats:title>\n                <jats:p>A 33-year-old Asian woman, para 3 at full term pregnancy, admitted to the intensive care unit (ICU) after c-section and tubectomy due to shortness of breath and palpitation. Based on history taking, physical examination and echocardiography the patient fulfilled the criteria of PPCM which was also complicated by pulmonary edema. Despite impending respiratory failure, the patient rejected intubation and continuous positive airway pressure\u00a0(CPAP), and was given oxygen supplementation through nasal cannula. Furosemide was given rapidly continued by maintenance dose and CVP was monitored. Antihypertensive drug, anticoagulants, and bromocriptine were also administered. After achieving negative cumulative fluid balance the patient\u2019s symptoms resolved and was discharged one\u00a0week later.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>There is a correlation between negative cumulative fluid balance and reduced central venous pressure after early furosemide therapy. Suspicion for PPCM should not be lowered in the presence of preeclampsia, it could delay appropriate treatment and increase the mortality.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-024-04398-2","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T01:07:26Z","timestamp":1707700046000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Guyton perspective in managing peripartum cardiomyopathy patient with pulmonary edema: a case report"],"prefix":"10.1186","volume":"18","author":[{"given":"Ruth Evlin","family":"Margaretha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohanes W. H.","family":"George","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jefferson","family":"Hidayat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,12]]},"reference":[{"key":"4398_CR1","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1093\/eurjhf\/hfq120","volume":"12","author":"K Sliwa","year":"2010","unstructured":"Sliwa K, Hilfiker-Kleiner D, Petrie MC, Mebazaa A, Pieske B, Buchmann E, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of peripartum cardiomyopathy: a position statement from the Heart Failure Association of the European Society of Cardiology Working Group on peripartum cardiomyopathy. Eur J Heart Fail. 2010;12:767\u201378.","journal-title":"Eur J Heart Fail"},{"key":"4398_CR2","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1001\/jama.283.9.1183","volume":"283","author":"GD Pearson","year":"2000","unstructured":"Pearson GD, Velle JC, Rahimtoola S, et al. Peripartum cardiomyopathy: National Heart, Lung, and Blood Institute and Office of Rare Diseases (National Institute of Health) workshop recommendation and review. JAMA. 2000;283:1183\u20138.","journal-title":"JAMA"},{"key":"4398_CR3","first-page":"311","volume":"94","author":"JU Hibbard","year":"1999","unstructured":"Hibbard JU, Lindheimer M, Lang RM. A modified definition for peripartum cardiomyopathy and prognosis based on echocardiography. Obstet Gynecol. 1999;94:311\u20136.","journal-title":"Obstet Gynecol"},{"key":"4398_CR4","doi-asserted-by":"crossref","unstructured":"Elkayam U, et al. Pregnancy-associated cardiomyopathy: clinical characteristics and a comparison between early and late presentation. University of Southern California Keck School of Medicine. 2005; http:\/\/www.circulationaha.org.","DOI":"10.1161\/01.CIR.0000162478.36652.7E"},{"key":"4398_CR5","unstructured":"Mubarik A, Chippa V, Iqbal AM. Postpartum cardiomyopathy. 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534770\/."},{"key":"4398_CR6","doi-asserted-by":"crossref","unstructured":"Arany Z, Elkayam U. Peripartum Cardiomyopathy. University of Southern California, Los Angeles. 2016; http:\/\/www.circulationaha.org.","DOI":"10.1161\/CIRCULATIONAHA.115.020491"},{"key":"4398_CR7","unstructured":"Elkayam U. Clinical Characteristics of Peripartum Cardiomyopathy in the United States. August 9, 2011. University of Southern California Keck School of Medicine. 2011; http:\/\/www.circulationaha.org."},{"issue":"6","key":"4398_CR8","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1016\/j.tcm.2015.01.004","volume":"25","author":"NA Bello","year":"2015","unstructured":"Bello NA, Arany Z. Molecular mechanisms of peripartum cardiomyopathy: a vascular\/hormonal hypothesis. Trends Cardiovasc Med. 2015;25(6):499\u2013504.","journal-title":"Trends Cardiovasc Med"},{"issue":"4","key":"4398_CR9","first-page":"403","volume":"51","author":"M Figueroa","year":"2006","unstructured":"Figueroa M, Peters JI. Congestive heart failure: diagnosis, pathophysiology, therapy, and implications of respiratory care. Respir Care. 2006;51(4):403\u201312.","journal-title":"Respir Care"},{"key":"4398_CR10","doi-asserted-by":"publisher","first-page":"9A","DOI":"10.1016\/0002-9149(85)90790-8","volume":"55","author":"W Parmley","year":"1985","unstructured":"Parmley W. Pathophysiology of congestive heart failure. Am J Cardiol. 1985;55:9A-14A.","journal-title":"Am J Cardiol"},{"key":"4398_CR11","volume-title":"Heart failure: pathophysiology and clinical picture","author":"A Palazzuoli","year":"2010","unstructured":"Palazzuoli A, Ranuccio N. Heart failure: pathophysiology and clinical picture. Italy: University of Siena; 2010."},{"key":"4398_CR12","doi-asserted-by":"crossref","unstructured":"Miserocchi G, Beretta E. Pathophysiology of extravascular water in the pleural cavity and in the lung interstitium after lung thoracic surgery. 2012. Universita degli Studi di Milani-Bicocca. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534770\/","DOI":"10.5772\/25788"},{"key":"4398_CR13","doi-asserted-by":"publisher","first-page":"2788","DOI":"10.1056\/NEJMcp052699","volume":"353","author":"LB Ware","year":"2005","unstructured":"Ware LB, Matthay MA. Acute pulmonary edema. 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Eur J Heart Fail. 2018;21:137\u201355.","journal-title":"Eur J Heart Fail"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04398-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-024-04398-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-024-04398-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T01:09:10Z","timestamp":1707700150000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-024-04398-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,12]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4398"],"URL":"https:\/\/doi.org\/10.1186\/s13256-024-04398-2","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,12]]},"assertion":[{"value":"2 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 February 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Author has acquired ethics approval from Semen Padang Hospital Committee of Ethics and also consent to participate from the patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declared that they have no competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"87"}}