Two cases of coronavirus 2019-related cardiomyopathy in pregnancy

Am J Obstet Gynecol MFM. 2020 May;2(2):100113. doi: 10.1016/j.ajogmf.2020.100113. Epub 2020 Apr 3.

Abstract

At our institution, 2 of the initial 7 pregnant patients with confirmed coronavirus disease 2019 severe infection (28.6%; 95% CI, 8.2%-64.1%) developed cardiac dysfunction with moderately reduced left ventricular ejection fractions of 40%-45% and hypokinesis. Viral myocarditis and cardiomyopathy have also been reported in nonpregnant coronavirus disease 2019 patients. A case series of nonpregnant patients with coronavirus disease 2019 found that 33% of those in intensive care developed cardiomyopathy. More data are needed to ascertain the incidence of cardiomyopathy from coronavirus disease 2019 in pregnancy, in all pregnant women with coronavirus disease 2019, and those with severe disease (eg, pneumonia). We suggest an echocardiogram in pregnant women with coronavirus disease 2019 pneumonia, in particular those necessitating oxygen, or those who are critically ill, and we recommend the use of handheld, point-of-care devices where possible to minimize contamination of staff and traditional large echocardiogram machines.

Keywords: COVID-19; cardiomyopathy; novel coronavirus; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Arrhythmia Agents / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Anticonvulsants / therapeutic use
  • Blood Gas Analysis
  • COVID-19 / complications
  • COVID-19 / diagnosis
  • COVID-19 / physiopathology
  • COVID-19 / therapy*
  • COVID-19 Nucleic Acid Testing
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / etiology
  • Cardiomyopathies / physiopathology
  • Cardiomyopathies / therapy*
  • Cesarean Section*
  • Diabetes, Gestational
  • Diuretics / therapeutic use
  • Echocardiography
  • Enzyme Inhibitors / therapeutic use
  • Female
  • Fever
  • Furosemide / therapeutic use
  • Heart Arrest / etiology
  • Heart Arrest / therapy
  • Heart Failure / diagnosis
  • Heart Failure / etiology
  • Heart Failure / physiopathology
  • Heart Failure / therapy*
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Hypoxia / etiology
  • Hypoxia / therapy
  • Intubation, Intratracheal
  • Magnesium Sulfate / therapeutic use
  • Metoprolol / therapeutic use
  • Middle Aged
  • Obesity, Maternal / complications
  • Oxygen Inhalation Therapy
  • Point-of-Care Systems
  • Pre-Eclampsia / drug therapy
  • Pre-Eclampsia / physiopathology
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / diagnosis
  • Pregnancy Complications, Cardiovascular / physiopathology
  • Pregnancy Complications, Cardiovascular / therapy*
  • Pregnancy Complications, Infectious / diagnosis
  • Pregnancy Complications, Infectious / physiopathology
  • Pregnancy Complications, Infectious / therapy*
  • Respiration, Artificial*
  • Return of Spontaneous Circulation
  • SARS-CoV-2
  • Severity of Illness Index
  • Stroke Volume
  • Tachycardia / drug therapy
  • Tachycardia / physiopathology
  • Tachycardia, Supraventricular / drug therapy
  • Tachycardia, Supraventricular / etiology

Substances

  • Anti-Arrhythmia Agents
  • Antibodies, Monoclonal, Humanized
  • Anticonvulsants
  • Diuretics
  • Enzyme Inhibitors
  • Hydroxychloroquine
  • Magnesium Sulfate
  • Furosemide
  • Metoprolol
  • tocilizumab