Undiagnosed adult congenital heart disease presenting with postpartum dyspnoea: a case report

• DOI: 10.1002/ehf2.12868
• Publication Date: 2020-06-26T06:10:30Z
• Authors: Hendrik Thoen; Lien Moreel; Bert Adriaenssens; Siegmund Keuleers; Joeri Voet
• Keywords: Ductus arteriosus; Pulmonary angiography

Abstract Patients with adult congenital heart disease are born structural defects who survived into adulthood. Occasionally, complex lesions remain undiagnosed, potentially causing substantial cardiovascular health problems at young age. Here, the case is presented of a patient subacute failure 1 week postpartum, revealing diagnosis aortic coarctation (CoA) patent ductus arteriosus (PDA). A 34‐year‐old woman to emergency department severe hypertension and exercise‐related dyspnoea postpartum. An initial pulmonary embolism was made after detection solitary opacity in artery (PA) on CT angiography. Symptoms persisted despite anticoagulant treatment. Thorough clinical echocardiographic reassessment unmasked CoA PDA, which treated percutaneous dilatation stenting. Follow‐up consultation 4 weeks later showed an asymptomatic normalized blood pressure. The puerperium high‐risk period develop hypertensive for mothers pre‐existing disease, due mobilization extracellular fluid intravascular compartment. Undiagnosed should always be ruled out unexplained postpartum hypertension. When detecting PA, PDA associated excluded by further investigations. This located orifice PA probably flow effect, results from mix contrast‐free contrast‐rich blood.