Heart Failure with Preserved Ejection Fraction in a Postpartum Patient with Superimposed Preeclampsia and COVID-19

• Published in: American journal of perinatology reports Vol. 10; no. 2; pp. e165 - e168
• Main Authors: Sinkey, Rachel G., Rajapreyar, Indranee, Robbins, Lindsay S., Dionne-Odom, Jodie, Pogwizd, Steven M., Casey, Brian M., Tita, Alan T.N.
• Format: Journal Article
• Language: English
• Published: 333 Seventh Avenue, New York, NY 10001, USA Thieme Medical Publishers 01.04.2020; Thieme Medical Publishers, Inc
• Subjects: Case Report; covid-19; heart failure with preserved ejection fraction; hypertensive emergency; preeclampsia; COVID-19; heart failure with preserved ejection fraction; hypertensive emergency; preeclampsia
• ISSN: 2157-6998; 2157-7005
• DOI: 10.1055/s-0040-1712926

Abstract Our understanding of COVID-19 in pregnant and postpartum women is rapidly evolving. We present a case from March 2020 of a 25-year-old G2P2002 whose delivery was complicated by preeclampsia with severe features who presented to the emergency department 9 days after cesarean delivery with chest tightness and dyspnea on exertion. On presentation she had severe hypertension, pulmonary edema, elevated brain natriuretic peptide, and high-sensitivity troponin-I, suggesting a diagnosis of hypertensive emergency leading to heart failure with a preserved ejection fraction resulting in pulmonary edema and abnormal cardiac screening tests. However, bilateral opacities were seen on a computed tomography of the chest, and COVID-19 testing was positive. A high index of suspicion for both COVID-19 and cardiovascular complications are critical for optimal patient outcomes and protection of health care workers.