128 AN UNEXPECTED ENDING OF PREGNANCY

Abstract Introduction Dilated cardiomyopathy (DCM) is a condition whose etiologies may be various. DCM with ventricular disfunction frequent complication of chemotherapy. Peripartum characterized by reduced ejection fraction (EF), presenting toward the end pregnancy or in first months after delivery. Lipodystrophy associated to dilated and hypertrophic cardiomyopathy. Material Methods A 28-years-old pregnant woman her late 33rd week was admitted acute heart failure complicated pulmonary edema. The patient had history lymphoblastic leukemia during childhood treated chemo radiotherapy, followed hematopoietic stem cell transplantation (HSCT). Afterwards she developed partial acquired lipodystrophy, causing diabetes mellitus, insulin resistance, dyslipidemia, leptin deficiency steatohepatitis. mild left been reported before HSCT, complete recovery at follow up. After admission, scenary rapidly deteriorated towards cardiogenic shock, so caesarean section performed. Transthoracic echocardiography revealed diffuse hypokinesia conditioning severe (LV) dysfunction (EF 24%), moderate mitral tricuspidal valve regurgitation right shunt possible atrial septal defect. cycle levosimendan administrated, subsequent improvement LV function 32%). Cardiac magnetic resonance (CMRI) showed hypokinetic no pathological findings T1, T2, STIR sequences nor LGE. In parallel, empty sella Sheehan Syndrome hypothesized. diagnosis peripartum on basis chemotherapy-induced good compensation status made, evidence lipodystrophy-related cardiac involvement. discharged optimal cardiological therapy wearable cardioverter defibrillator. During up, improved 40%) without any registered arrhythmia. She will evaluated for transplantation. Conclusions Pregnancy patients disease can life-threatening mother fetus, multidisciplinary approach correct timing are crucial achieve best result. Left related many etiologies, instrumental tests such as echocardiogram CMRI evaluate cause disfunction. Close up who underwent chemo/radiotherapy affected metabolic diseases avoid long-term complications.