RESUMO
Peripartum Cardiomyopathy (PPCM) is a clinical condition of heart failure that occurs in the last trimester of pregnancy or after childbirth in the early postpartum period. The aetiology of this condition is still uncertain, but it is connected with high mortality and morbidity. PPCM can be difficult to find because the symptoms of heart failure can resemble those of late pregnancy, such as swelling of the feet and legs, orthopnea and paroxysmal nocturnal dyspnea. PPCM is diagnosed with Hibbard diagnostic criteria which are heart failure in the last month of pregnancy and 5 months after birth, lack of previous heart disease, there is no definitive cause and strict echocardiography of left ventricular dysfunction: Left Ventricular Ejection Fraction (LVEF) <45% and/or M-model fraction <30% and Left Ventricular End Diastolic dimension (LVEDd) greater than 2.7 cm/m2. A multidisciplinary strategy involving cardiologist, obstetrician, intensivist and paediatrician is vital for the management of PPCM patients.
RESUMO
The anterior mediastinal cysts and masses (AMCM) can be of varied origin and presentation. Although the space in the mediastinum is limited the cysts and masses can grow to a large size before the presentation. They displace the adjacent structures and then can grow into the pleural cavities thereby acquiring a large size. We share our experience of a case of a huge anterior mediastinal cystic mass in a young female who had a characteristic presentation of sudden onset breathlessness in the supine position and immediate relief in the sitting position. The patient recovered well after surgical treatment.