Medical MCQ - A multi-parous P3L3 young lady who delivered normally 3 weeks ago suddenly developed dyspnea with cardiac failure. She has no H/O cardiac disease before /during pregnancy. She had tachycardia and peripheral edema. Her hemoglobin was 9 gm/dl. Her Echo has revealed an EF of 35%. Which one of the following is the most likely diagnosis?

A multi-parous P3L3 young lady who delivered normally 3 weeks ago suddenly developed dyspnea with cardiac failure. She has no H/O cardiac disease before /during pregnancy. She had tachycardia and peripheral edema. Her hemoglobin was 9 gm/dl. Her Echo has revealed an EF of 35%. Which one of the following is the most likely diagnosis?

Acute MI

Deep vein thrombosis with pulmonary embolism

Amniotic fluid embolism

Peri-paum cardiomyopathy

Question Category:

Medicine

Correct Answer:

Peri-paum cardiomyopathy

Description:

Acute Ml Ruled out as chest pain at rest, elevated cardio-markers or ECG changes are not present. DVT with PE Develops suddenly and is a close answer but point against is Echo finding of only low ejection fraction. In PE, Echo shows RV dyskinesia with or without tricuspid regurgitation. The interventricular septal detion is also seen Amniotic fluid embolism Ruled out as it occurs immediately during active labour Peri-paum cardiomyopathy PPCM is diagnosed when the following 3 criteria are met: 1. Hea failure develops in the last month of pregnancy or within 5 months of delivery. 2. Hea pumping function is reduced, with an ejection fraction (EF) less than 45% 3. No other cause for hea failure with reduced EF can be found. In this question anemia, Ml and Pulmonary embolism have been ruled out

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