Journal Article

Case 39-2009

Shepard, Jo-Anne O, O'Gara, Patrick T, Yared, Kibar, Sohani, Aliyah R

2009

Overview

A 28-year-old woman was admitted to this hospital 2 days post partum because of cardiac failure. Four weeks earlier, at approximately 29 weeks' gestation, retrosternal chest discomfort developed, followed by shortness of breath, myalgias, and fatigue. Echocardiography revealed a pericardial effusion, with tamponade and biventricular hypokinesis. Despite pericardiocentesis and cesarean section at 32 weeks, her condition worsened. Radiographs obtained at this hospital showed a widened mediastinum; echocardiography revealed thickening of the pericardium and abnormal material surrounding the great vessels. A diagnostic procedure was performed. A 28-year-old woman was admitted to the hospital 2 days post partum because of cardiac failure. At approximately 29 weeks' gestation, retrosternal chest discomfort had developed, followed by shortness of breath, myalgias, and fatigue. Presentation of Case Dr. Brad W. Butcher (Medicine): A 28-year-old woman was admitted to this hospital 2 days post partum because of cardiac failure. The patient had been well, except for gestational diabetes mellitus, until 4 weeks earlier (approximately 29 weeks' gestation), when retrosternal chest discomfort developed, followed by shortness of breath, myalgias, and fatigue. One week later, she went to the emergency department of another hospital. Laboratory-test results are shown in Table 1. Cephalexin and a proton-pump inhibitor were prescribed. Two days later, she returned to the hospital because of persistent symptoms. She had no fevers, night sweats, upper respiratory . . .

• Publisher: Massachusetts Medical Society
• Subject: Blood pressure / Hepatitis / Medical diagnosis / Ultrasonic imaging