Background: Peripartum cardiomyopathy and doxorubicin-induced cardiomyopathy are well described conditions but there is little description in the literature of both occurring together.
Case: A 29 year old G1P0 with a remote history of childhood chondroblastic osteosarcoma treated with high-dose doxorubicin therapy who developed minimally symptomatic cardiomyopathy during her pregnancy with ejection fraction reaching as low as 20-30%. She delivered via primary low-transverse cesarean section at 37 weeks complicated by uterine atony with an unremarkable recovery. Cardiomyopathy was treated with metoprolol and enalapril and she achieved ejection fraction of 44% at one year follow-up with complete return to baseline activity.
Discussion: We present a woman with a history of doxorubicin therapy who developed peripartum cardiomyopathy and recovered symptomatically after one year. Although treatment of peripartum cardiomyopathy regardless of etiology is well-defined, there are few reports and no standard guidelines for special considerations in pregnant women with a history of doxorubicin therapy, a topic that may warrant further investigation.
Peripartum cardiomyopathy, doxorubicin, osteosarcoma
The authors report no conflict of interest
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Akella SS, Shaffer SA. Peripartum cardiomyopathy with a history of doxorubicin therapy: case report & review of literature. Proc Obstet Gynecol. 2018 Feb 28;8(1):Article 5 [8 p.]. https://doi.org/10.17077/2154-4751.1377. Free full text article.