Case 2-2021: A 26-Year-Old Pregnant Woman with Ventricular Tachycardia and Shock

This case report describes a 26 year old pregnant woman with a monochorionic, diamniotic twin pregnancy who presented with ventricular tachycardia and cardiogenic shock. The patient had a history of gestational diabetes and polyhydramnios. Initial symptoms included leg edema and preterm labor, followed by sudden cardiac arrest due to ventricular tachycardia. Imaging revealed biventricular cardiomyopathy, and she was managed with ECMO and a temporary LVAD. Coronary angiography suggested spontaneous coronary artery dissection (SCAD) as the likely cause of myocardial infarction. Despite initial stabilization, she required a durable LVAD and eventual cardiac transplantation. The case highlights the complexities of managing cardiovascular emergencies in pregnancy and the diagnostic challenges in differentiating myocarditis, peripartum cardiomyopathy, and SCAD.

This case report describes a 26 year old pregnant woman with a monochorionic, diamniotic twin pregnancy who presented with ventricular tachycardia and cardiogenic shock. The patient had a history of gestational diabetes and polyhydramnios. Initial symptoms included leg edema and preterm labor, followed by sudden cardiac arrest due to ventricular tachycardia. Imaging revealed biventricular cardiomyopathy, and she was managed with ECMO and a temporary LVAD. Coronary angiography suggested spontaneous coronary artery dissection (SCAD) as the likely cause of myocardial infarction. Despite initial stabilization, she required a durable LVAD and eventual cardiac transplantation. The case highlights the complexities of managing cardiovascular emergencies in pregnancy and the diagnostic challenges in differentiating myocarditis, peripartum cardiomyopathy, and SCAD.