Miocardiopatía periparto: Un puerperio inesperado

Abstract

Peripartum cardiomyopathy is a disorder of unknown origin wherein left ventricular dysfunction and heart failure symptoms appear between the last month of pregnancy and the first five months after delivery in women without pre-existing signs or symptoms of heart disease. We present a case report of a 30-year-old puerpera who presented with a dyspneic sensation from the first day after delivery, which progressed to minimal exertion dyspnea, with orthopnea, paroxysmal nocturnal dyspnea and increasing lower limb edema. She was admitted to the Coronary Intensive Care Unit with congestive heart failure, cardiogenic shock and dilated cardiomyopathy with severe systolic dysfunction of the left ventricle. The aim of this case was to develop the most relevant aspects of its care from the perspective of nursing. An individualized care plan was developed evaluating therefor the 14 needs according to Virginia Henderson’s model. As nursing diagnoses, discontinuation of breast feeding and ineffective coping stand out. During her stay, the patient remained stable, and she was then discharged to continue with surveillance and treatment. The role of nursing was essential in the emotional approach to the patient, due to the impact that her serious condition on admission had on her and to her fear of a still unknown prognosis in the long term, in addition to being abruptly separated from her newborn child. The individualized care plan turned out to be an essential tool for the patient’s management.