Subscribe to RSS
DOI: 10.1055/s-0036-1593235
A case of left ventricular noncompaction in pregnancy and its interdisciplinary management
Introduction: Left ventricular hypertrabeculation/noncompaction (LVHT) is a cardiac abnormality of unknown etiology, characterized by extensive trabeculations of the left ventricular cavity. LVHT is no contraindication for pregnancy, however worsening of cardiac function and development of malignant arrhythmias has been described. Protection against malignant arrhythmias can be provided by implanted defibrillators (ICDs). We present the first LVHT case with a lifevest (Firma Zoll) during pregnancy.
Case report: A 27-years old woman with a diagnosis of LVHT presented within the 16th week of pregnancy. Echocardiography showed a left ventricular ejection fraction of 43%. Her sister, also suffering from LVHT, had died at age 19 years despite an implanted cardioverter-defibrillator (ICD) and her father suddenly at age 34 years. At completed 25 weeks of gestation RDS-prophylaxis was given. Since multiple ventricular ectopic beats and short ventricular ectopic runs were detected, it was decided to provide her with a lifevest. Within the 34th week of gestation she was hospitalized. Daily CTGs and weekly Doppler-recordings of the umbilical cord detected no abnormalities. The primary Ceaesarean-section was scheduled at 37 gestational weeks and carried out without any problems in epidural anesthesia. Postpartal development was excellent for mother and child. The child did not show any cardiac abnormalities.
Conclusion: In view of the limited data and experience with the course of pregnancy in LVHT-patients, a close interdisciplinary monitoring between cardiologist, gynecologists, anaesthesiologists and neonatologists should be carried out. A wearable defibrillator is an alternative to protect against sudden death if an ICD is either unsuitable or undecided.