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Medline ® Abstract for Reference 30

of 'Peripartum cardiomyopathy: Treatment and prognosis'

Recovery from peripartum cardiomyopathy after treatment with bromocriptine.
Habedank D, Kühnle Y, Elgeti T, Dudenhausen JW, Haverkamp W, Dietz R
Eur J Heart Fail. 2008;10(11):1149. Epub 2008 Oct 15.
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.
Department of Cardiology, Charité- Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany. dirk.habedank@charite.de