Beatriz Amaral Costa Savino

University of Campinas,
Brazil

Abstract Title: Noncompaction Myocardium and Puerperium: Case Report

Biography:

Beatriz Amaral Costa Savino is a physician specializing in Internal Medicine and a Master's Student at the Hospital de Clinicas of the State University of Campinas (Unicamp), São Paulo, Brazil. With a strong academic background and dedication to patient-centered medicine, her research and clinical interests focus on advancing cardiovascular care, critically ill patient and medical education.

Research Interest:

Introduction: Noncompacted Myocardium Cardiomyopathy (NMC) is a rare condition characterized by abnormal trabeculations in the left ventricle, with a prevalence ranging from 0.9% to 9.8%. During pregnancy, physiological adaptations fail to counterbalance increased maternal hemodynamic demands, and women with preexisting cardiomyopathies may have exacerbation of symptoms of the underlying condition.

Case Report: A 30-year-old female with a history of unspecified congenital heart disease and no regular follow-up developed dyspnea during pregnancy, which worsened postpartum. She progressed to dyspnea on minimal exertion, orthopnea, lower limb edema, and paroxysmal nocturnal dyspnea. She was admitted to the emergency department with symptoms of Heart Failure Profile C and was treated with inotropes and diuretics. Transthoracic Echocardiography revealed global cardiac chamber dilation, eccentric hypertrophy, diastolic dysfunction, and severe systolic dysfunction in both ventricles with left ventricular ejection fraction of 20%, suggestive of cardiomyopathy. Cardiac Magnetic Resonance Imaging confirmed the diagnosis of NMC, showing late enhancement in the left ventricle lateral wall and excessive trabeculation. After stabilization, she maintained severe heart failure with debilitating symptoms despite optimized medical therapy and was listed for heart transplantation in April 2024.

Discussion and Conclusion: NMC results from a failure in myocardial compaction during embryonic development, leading to excessive trabeculations and an increased risk of arrhythmias, thromboembolic events, and heart failure. Pregnancy-related hemodynamic changes, such as increased cardiac output, blood volume, and heart rate, as well as reduced peripheral vascular resistance, can exacerbate ventricular dysfunction in individuals with cardiomyopathies, as observed in this case. Therefore, early diagnosis and timely intervention are crucial for optimizing patient prognosis and mitigating disease progression, thereby reducing the risk of requiring a heart transplant, as illustrated in this report.