Management of Respiratory Failure in Peripartum Cardiomyopathy Patient: Case Report

Introduction: Respiratory failure in peripartum cardiomyopathy is a lethal risk. The onset of respiratory failure in peripartum cardiomyopathy is due to left-to-right heart failure, which lowers PaO2. Unfortunately, symptoms of peripartum cardiomyopathy are often non-specific and progressive, so diagnosis and treatment are frequently delayed. Case: A woman, 41 years old, 35-36 weeks pregnant, complains of shortness of breath for four days, worsening one day before hospitalization. Cough (-), The patient has no history of heart disease; this is her 5th pregnancy, and she has never complained of the same thing in previous pregnancies. physical examination of consciousness, compost mentis,BP 90/60 mmHg, HR 122 x/i, RR 32-36 x/I, T 36.5 °C,, Spo2 is 85% without O2. On examination, blood gas analysis showed a respiratory alkalosis with type 1 respiratory failure. The patient underwent an emergency cesarean section on the indication of type 1 respiratory failure—postoperative care in the ICU with the installation of a ventilator. During the five days of treatment, the patient's condition improved when transferred to the ward. Discussion: Respiratory failure in peripartum cardiomyopathy results from a low PaO2, usually accompanied by an accumulation of fluid in the interstitial lung tissue (pulmonary edema), which exacerbates hypoxaemic conditions due to decreased cardiac output. Airway protection is significant, such as performing mechanical ventilation with sedation to optimize oxygen delivery; giving inotropic (digoxin) and vasoactive drugs (dopamine or dobutamine) to increase contractility and maintain mean arterial pressure (MAP) for organ perfusion; reducing preload and afterload; and maintaining negative fluid balance while paying attention to adequate organ perfusion. Conclusion: Airway patency is the primary key in the management of respiratory failure in patients with peripartum cardiomyopathy