Clinical Studies on 40 Cases of Postpartum Heart Failure

ABSTRACT

Fourty cases of postpartum heart failure occuring in Korean women in the Dept. of Int. Med., Pusan University Hospital are reported, with and analysis of clinical data including frequency, age, time of onset, clinical features, hemoglobin, liver function, electrocardiographic and chest X-ray findings. The following results were obtained. 1. The cases were mostly found in 20-29 years age group, 50% of the total cases. 2. Eighteen cases of fourty patients experienced the symptoms during the 2nd week after delivery and 12 cases complained the symptoms during 4th week. 3. Only six cases noted onset of heart disease following the 4th pregnancy, whereas sixteen patients experienced this phenomenon after the first gestation, eight patients after the 2nd gestation and ten patients after the 3rd pregnancy. 4. At the admission the patients were suffering from paroxysmal nocturnal dyspnea, orthopnea, exertional dyspnea and generalized edema. Physical findings revealed cardiomegaly, gallop rhythm, edema, pulmonary fine rales and systolic murmur in frequency. 5. Electrocardiograms were available at the time of presentation in thirty patients. Twenty four patients had left ventricular hypertrophy, 18 patients sinus tachycardia, 3 patients lower voltage. 6. The chest X-ray film showed the cardiomegaly in 15 cases, 83.3% of the obtained 18 cases, 12 cases pulmonary edema, 3 cases pericardial effusion. 7. The venous pressure was measured in 15 patients. In 5 cases the venous pressure was normal and in 10 increased above 150mmH2O. 8. With prompt treatment by rest, salt restriction, diuretics and digoxin the clinical symptoms improved in 31 cases but 9 patients died at the admission.