[Acute early postpartum cardiac failure associated with dilated cardiomyopathy: successful treatment with intra-aortic balloon counter-pulsation and levosimendan]. / Défaillance cardiaque aiguë associée à une cardiomyopathie dilatée en post-partum précoce: traitement par ballon de contrepulsion aortique et lévosimendan.

ABSTRACT

The use of levosimendan (Simdax(®)) was described in cases of acute cardiac failure in patients with peripartum cardiopmyopathy. We report the case of a 36 years old Philippine woman with an undiagnosed dilated myocardiopathy. She developed an acute severe left ventricular dysfunction in the early postpartum period after a cesarean section, possibly related to the recurrence of an unknown peripartum myocardiopathy. Due to failure of the conventional treatment with diuretics and inotropic support, an intra-aortic balloon with counter-pulsation was inserted. In rescue, treatment with levosimendan permitted to wean the patient from haemodynamic support, and a heart transplant was probably avoided. Three months later, a new echocardiography showed a persistent left ventricular dilation and a still marked alteration of left ventricular ejection fraction (28%).