Peripartum cardiomyopathy presenting as lower extremity arterial thromboembolism - A case report

BACKGROUND: Although venous thromboembolism has been associated with peripa rtum cardiomyopathy, there have been no prior reports of lower extremity ar terial thromboembolism complicating cardiac failure. CASE: A 38-year-old woman, gradiva 5, para 5, presented on postpartum day 9 with left pedal parasthesia. Lower extremity angiography found acute throm botic emboli in the left popliteal artery, right tibial artery and right pe roneal artery. When respiratory decompensation ensued, a transthoracic echo cardiogram revealed global hypokinesis and a left ventricular ejection frac tion of 30%. The patient had an uneventful recovery after treatment with di goxin, furosemide and intravenous heparin. CONCLUSION: Lower extremity arterial thromboembolism may be the initial man ifestation of peripartum cardiomyopathy.