Peripartum cardiomyopathy and antiphospholipid syndrome: a rare association revealed by a right ventricular thrombus. A case report
- 1Instituto Nacional Cardiovascular, INCOR-EsSalud, Lima, Peru. Instituto Nacional Cardiovascular INCOR-EsSalud Lima Peru
Abstract
Peripartum cardiomyopathy (PPCM) is uncommon, and its association with antiphospholipid syndrome (APS) and right ventricular (RV) thrombus is exceptional. We report a 33-year-old woman who, three months after cesarean delivery for severe preeclampsia, developed acute heart failure with severe biventricular dysfunction requiring mechanical ventilation. An RV thrombus was identified; two computed tomographic pulmonary angiograms, one week apart, were negative for pulmonary embolism. Thrombophilia work-up disclosed persistently positive lupus anticoagulant on repeat testing 12 weeks apart, supporting APS. Therapeutic anticoagulation led to complete thrombus resolution after 10 days, and optimized heart failure therapy was followed by hemodynamic improvement and successful extubation. Coronary angiography ruled out ischemic heart disease, and endomyocardial biopsy showed no histologic evidence of myocarditis, supporting PPCM. Myocardial recovery was partial, requiring follow-up within an advanced heart failure program. This case highlights the need to evaluate secondary prothrombotic conditions, particularly APS, and to institute early anticoagulation in PPCM with intracardiac thrombosis.
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BibTeX
@article{vallejosbarrientos2026peripartum,
title = {{Peripartum cardiomyopathy and antiphospholipid syndrome: a rare association revealed by a right ventricular thrombus. A case report}},
author = {Alexis Vallejos-Barrientos and Diego Davila-Flores and Ofelia Araoz-Tarco},
journal = {Archivos Peruanos de Cardiología y Cirugía Cardiovascular},
year = {2026},
month = sep,
doi = {10.47487/apcyccv.v7i3.581},
url = {https://doi.org/10.47487/apcyccv.v7i3.581},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Peripartum cardiomyopathy and antiphospholipid syndrome: a rare association revealed by a right ventricular thrombus. A case report
AU - Alexis Vallejos-Barrientos
AU - Diego Davila-Flores
AU - Ofelia Araoz-Tarco
PY - 2026
DA - 2026/09/26
JO - Archivos Peruanos de Cardiología y Cirugía Cardiovascular
DO - 10.47487/apcyccv.v7i3.581
UR - https://doi.org/10.47487/apcyccv.v7i3.581
AB - Peripartum cardiomyopathy (PPCM) is uncommon, and its association with antiphospholipid syndrome (APS) and right ventricular (RV) thrombus is exceptional. We report a 33-year-old woman who, three months after cesarean delivery for severe preeclampsia, developed acute heart failure with severe biventricular dysfunction requiring mechanical ventilation. An RV thrombus was identified; two computed tomographic pulmonary angiograms, one week apart, were negative for pulmonary embolism. Thrombophilia work-up disclosed persistently positive lupus anticoagulant on repeat testing 12 weeks apart, supporting APS. Therapeutic anticoagulation led to complete thrombus resolution after 10 days, and optimized heart failure therapy was followed by hemodynamic improvement and successful extubation. Coronary angiography ruled out ischemic heart disease, and endomyocardial biopsy showed no histologic evidence of myocarditis, supporting PPCM. Myocardial recovery was partial, requiring follow-up within an advanced heart failure program. This case highlights the need to evaluate secondary prothrombotic conditions, particularly APS, and to institute early anticoagulation in PPCM with intracardiac thrombosis.
SN - 2708-7212
ER -