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Vol. 47. Issue 5.
Pages 241-248 (January 2004)
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Vol. 47. Issue 5.
Pages 241-248 (January 2004)
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Miocardiopatía periparto como causa de insuficiencia cardíaca durante la gestación
Peripartum cardiomyopathy as a cause of heart failure during pregnancy
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6845
W. Plasenciaa,
Corresponding author
walterplasencia@mixmail.com

Correspondencia: Servicio de Ginecología y Obstetricia. Hospital Universitario Materno Infantil de Canarias. Avda. Marítima del Sur, s/n. 35016 Las Palmas de Gran Canaria. España
, N. Castrob, M. Barbera, O. Falcóna, J.M. Vallsa, J. Guzmána, I. Eguiluza, J.A. Garcíaa
a Servicio de Ginecología y Obstetricia. Hospital Universitario Materno Infantil de Canarias. Las Palmas de Gran Canaria
b Servicio de Cardiología. Hospital General de Gran Canaria Dr. Negrín. Las Palmas de Gran Canaria. España
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Resumen

La miocardiopatía periparto es una rara forma de insuficiencia cardíaca que afecta a mujeres durante el embarazo tardío o puerperio, con consecuencias potencialmente letales. El cuadro clínico es el de una insuficiencia cardíaca congestiva, que a veces se puede pasar por alto debido a que puede tener síntomas similares a los de un embarazo normal, como la disnea. El tratamiento es similar al empleado en otros tipos de disfunción ventricular izquierda; sin embargo, a veces se requieren modificaciones del tratamiento estándar para seguridad de la madre y del feto o lactante. Salvo pocas excepciones, el parto vaginal con la abreviación del período expulsivo mediante fórceps es preferible en mujeres con enfermedad cardíaca, y un control hemodinámico exhaustivo de la paciente durante el puerperio inmediato es de extrema importancia. La mortalidad de este proceso se encuentra en torno al 30-40%, casi siempre durante los 3 primeros meses posparto, aunque alrededor del 50% de las pacientes tiene una marcada mejoría de la función ventricular.

Palabras clave:
Miocardiopatía periparto
Insuficiencia cardíaca
Cardiopatía
Embarazo
Abstract

Peripartum cardiomyopathy is a rare form of heart failure that affects women late in pregnancy or in the puerperium, with potentially fatal consequences. The clinical presentation is the same as in congestive heart failure, and sometimes the diagnosis is overlooked due to the occurrence of similar symptoms, such as dyspnea, during normal pregnancy. The treatment is similar to that for other types of left ventricular dysfunction. However, modifications to standard treatment are sometimes required for the safety of the mother and fetus. With few exceptions, vaginal delivery with a facilitated second stage with forceps is preferred in women with heart disease. Hemodynamic control of the patient during the early puerperium is highly important. Mortality estimates range from 30-40%; most deaths occur within the first three months postpartum, although 50% of patients show marked improvement in ventricular function.

Key Words:
Peripartum cardiomyopathy
Heart failure
Heart disease
Pregnancy
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Copyright © 2004. Sociedad Española de Ginecología y Obstetricia
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