Hearts Under Pressure: Challenging The Myocardium — A Critical Care Perspective

Abstract

Cardiac complications arising in the peripartum period represent a rare but life-threatening constellation of disorders that challenge multidisciplinary teams in critical care settings. We present three cases of acute cardiomyopathy in young obstetric patients: (1) Peripartum Cardiomyopathy (PPCM) with Posterior Reversible Encephalopathy Syndrome (PRES) following eclampsia; (2) Reverse Takotsubo Cardiomyopathy (TTS) precipitated by the stress of emergency abdominal surgery in the postpartum period; and (3) a case of Dilated Cardiomyopathy (DCM) diagnosed antenatally at 30 weeks of gestation. All three cases highlight the critical importance of timely echocardiographic evaluation, guideline-directed medical therapy, and a coordinated multidisciplinary approach. Prompt diagnosis and vigilant haemodynamic monitoring led to either complete recovery or significant clinical improvement in all patients. These cases underscore the need for clinicians to maintain a high index of suspicion for reversible and non-reversible cardiomyopathies in the peripartum setting.