Heart Failure with Preserved Ejection Fraction in a Postpartum Patient with Superimposed Preeclampsia and COVID-19.
Identifieur interne : 000178 ( Main/Corpus ); précédent : 000177; suivant : 000179Heart Failure with Preserved Ejection Fraction in a Postpartum Patient with Superimposed Preeclampsia and COVID-19.
Auteurs : Rachel G. Sinkey ; Indranee Rajapreyar ; Lindsay S. Robbins ; Jodie Dionne-Odom ; Steven M. Pogwizd ; Brian M. Casey ; Alan T N. TitaSource :
- AJP reports [ 2157-6998 ] ; 2020.
Abstract
Our understanding of COVID-19 in pregnant and postpartum women is rapidly evolving. We present a case from March 2020 of a 25-year-old G2P2002 whose delivery was complicated by preeclampsia with severe features who presented to the emergency department 9 days after cesarean delivery with chest tightness and dyspnea on exertion. On presentation she had severe hypertension, pulmonary edema, elevated brain natriuretic peptide, and high-sensitivity troponin-I, suggesting a diagnosis of hypertensive emergency leading to heart failure with a preserved ejection fraction resulting in pulmonary edema and abnormal cardiac screening tests. However, bilateral opacities were seen on a computed tomography of the chest, and COVID-19 testing was positive. A high index of suspicion for both COVID-19 and cardiovascular complications are critical for optimal patient outcomes and protection of health care workers.
DOI: 10.1055/s-0040-1712926
PubMed: 32509415
PubMed Central: PMC7272215
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Sinkey</name><affiliation><nlm:affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Rajapreyar, Indranee" sort="Rajapreyar, Indranee" uniqKey="Rajapreyar I" first="Indranee" last="Rajapreyar">Indranee Rajapreyar</name><affiliation><nlm:affiliation>Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Robbins, Lindsay S" sort="Robbins, Lindsay S" uniqKey="Robbins L" first="Lindsay S" last="Robbins">Lindsay S. Robbins</name><affiliation><nlm:affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Dionne Odom, Jodie" sort="Dionne Odom, Jodie" uniqKey="Dionne Odom J" first="Jodie" last="Dionne-Odom">Jodie Dionne-Odom</name><affiliation><nlm:affiliation>Division of Infectious Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Pogwizd, Steven M" sort="Pogwizd, Steven M" uniqKey="Pogwizd S" first="Steven M" last="Pogwizd">Steven M. 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Sinkey</name><affiliation><nlm:affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Rajapreyar, Indranee" sort="Rajapreyar, Indranee" uniqKey="Rajapreyar I" first="Indranee" last="Rajapreyar">Indranee Rajapreyar</name><affiliation><nlm:affiliation>Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Robbins, Lindsay S" sort="Robbins, Lindsay S" uniqKey="Robbins L" first="Lindsay S" last="Robbins">Lindsay S. Robbins</name><affiliation><nlm:affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Dionne Odom, Jodie" sort="Dionne Odom, Jodie" uniqKey="Dionne Odom J" first="Jodie" last="Dionne-Odom">Jodie Dionne-Odom</name><affiliation><nlm:affiliation>Division of Infectious Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Pogwizd, Steven M" sort="Pogwizd, Steven M" uniqKey="Pogwizd S" first="Steven M" last="Pogwizd">Steven M. Pogwizd</name><affiliation><nlm:affiliation>Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Casey, Brian M" sort="Casey, Brian M" uniqKey="Casey B" first="Brian M" last="Casey">Brian M. Casey</name><affiliation><nlm:affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author><author><name sortKey="Tita, Alan T N" sort="Tita, Alan T N" uniqKey="Tita A" first="Alan T N" last="Tita">Alan T N. Tita</name><affiliation><nlm:affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</nlm:affiliation></affiliation></author></analytic><series><title level="j">AJP reports</title><idno type="ISSN">2157-6998</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Our understanding of COVID-19 in pregnant and postpartum women is rapidly evolving. We present a case from March 2020 of a 25-year-old G2P2002 whose delivery was complicated by preeclampsia with severe features who presented to the emergency department 9 days after cesarean delivery with chest tightness and dyspnea on exertion. On presentation she had severe hypertension, pulmonary edema, elevated brain natriuretic peptide, and high-sensitivity troponin-I, suggesting a diagnosis of hypertensive emergency leading to heart failure with a preserved ejection fraction resulting in pulmonary edema and abnormal cardiac screening tests. However, bilateral opacities were seen on a computed tomography of the chest, and COVID-19 testing was positive. A high index of suspicion for both COVID-19 and cardiovascular complications are critical for optimal patient outcomes and protection of health care workers.</div></front></TEI><pubmed><MedlineCitation Status="PubMed-not-MEDLINE" Owner="NLM"><PMID Version="1">32509415</PMID><DateRevised><Year>2020</Year><Month>06</Month><Day>09</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">2157-6998</ISSN><JournalIssue CitedMedium="Print"><Volume>10</Volume><Issue>2</Issue><PubDate><Year>2020</Year><Month>Apr</Month></PubDate></JournalIssue><Title>AJP reports</Title><ISOAbbreviation>AJP Rep</ISOAbbreviation></Journal><ArticleTitle>Heart Failure with Preserved Ejection Fraction in a Postpartum Patient with Superimposed Preeclampsia and COVID-19.</ArticleTitle><Pagination><MedlinePgn>e165-e168</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1055/s-0040-1712926</ELocationID><Abstract><AbstractText>Our understanding of COVID-19 in pregnant and postpartum women is rapidly evolving. We present a case from March 2020 of a 25-year-old G2P2002 whose delivery was complicated by preeclampsia with severe features who presented to the emergency department 9 days after cesarean delivery with chest tightness and dyspnea on exertion. On presentation she had severe hypertension, pulmonary edema, elevated brain natriuretic peptide, and high-sensitivity troponin-I, suggesting a diagnosis of hypertensive emergency leading to heart failure with a preserved ejection fraction resulting in pulmonary edema and abnormal cardiac screening tests. However, bilateral opacities were seen on a computed tomography of the chest, and COVID-19 testing was positive. A high index of suspicion for both COVID-19 and cardiovascular complications are critical for optimal patient outcomes and protection of health care workers.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Sinkey</LastName><ForeName>Rachel G</ForeName><Initials>RG</Initials><AffiliationInfo><Affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rajapreyar</LastName><ForeName>Indranee</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Robbins</LastName><ForeName>Lindsay S</ForeName><Initials>LS</Initials><Identifier Source="ORCID">0000-0003-3334-1437</Identifier><AffiliationInfo><Affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dionne-Odom</LastName><ForeName>Jodie</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Division of Infectious Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pogwizd</LastName><ForeName>Steven M</ForeName><Initials>SM</Initials><AffiliationInfo><Affiliation>Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Casey</LastName><ForeName>Brian M</ForeName><Initials>BM</Initials><AffiliationInfo><Affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tita</LastName><ForeName>Alan T N</ForeName><Initials>ATN</Initials><AffiliationInfo><Affiliation>Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, Alabama.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>AJP Rep</MedlineTA><NlmUniqueID>101569862</NlmUniqueID><ISSNLinking>2157-7005</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">heart failure with preserved ejection fraction</Keyword><Keyword MajorTopicYN="N">hypertensive emergency</Keyword><Keyword MajorTopicYN="N">preeclampsia</Keyword></KeywordList><CoiStatement>Conflict of Interest None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>20</Day></PubMedPubDate><PubMedPubDate 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