Recovery from peripartum cardiomyopathy after treatment with bromocriptine

Eur J Heart Fail. 2008 Nov;10(11):1149-51. doi: 10.1016/j.ejheart.2008.09.001. Epub 2008 Oct 15.

Abstract

Peripartum cardiomyopathy (PPCM) is a potentially devastating cause of heart failure that affects women late in pregnancy or in early puerperium. Recent findings showed that a 16 kDa fragment of prolactin may induce myocardial damage, and this offered a new option of treating PPCM by blocking prolactin with bromocriptine. We report on a 35-year-old woman with a twin gravidity who gave birth to two healthy boys at day 36/6 and developed a potentially fatal PPCM. Within 3 days since delivery she suffered from severe symptoms of heart failure (orthopnoea, pleural and pericardial effusion, reduced systolic function LVEF 15%). Bromocriptine 2.5 mg bid was added to standard heart failure therapy at day 6 after delivery, and within a week the patient recovered to NYHA functional class II. 2 months later she presented in a good state, NYHA class I, and MRI confirmed an LVEF of 60%. Balancing the potential side effects of bromocriptine against the very poor prognosis in severe PPCM our case supports the use of bromocriptine as a specific novel therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bromocriptine / administration & dosage
  • Bromocriptine / therapeutic use*
  • Cardiomyopathies / complications
  • Cardiomyopathies / drug therapy*
  • Female
  • Follow-Up Studies
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy
  • Heart Failure / etiology
  • Hormone Antagonists / administration & dosage
  • Hormone Antagonists / therapeutic use*
  • Humans
  • Infant, Newborn
  • Magnetic Resonance Imaging
  • Male
  • Postpartum Period*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis
  • Pregnancy Complications, Cardiovascular / drug therapy*
  • Pregnancy Outcome
  • Recovery of Function*

Substances

  • Hormone Antagonists
  • Bromocriptine