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Scholars Journal of Medical Case Reports | Volume-14 | Issue-02
Peripartum Dilated Cardiomyopathy with End-Stage Left Ventricular Dysfunction Refractory to Medical and Electrical Therapy: A Case Report and Comprehensive Literature Review
Hafsa Erregui, Mehdi Moujahid, Najat Mouine, Aatif Benyass
Published: Feb. 7, 2026 |
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Pages: 219-224
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Abstract
Background: Peripartum cardiomyopathy (PPCM) is a rare and potentially life-threatening form of dilated cardiomyopathy presenting in late pregnancy or early postpartum. Although many patients recover left ventricular function, a subset progress to end-stage heart failure refractory to guideline-directed medical and device therapy, requiring heart transplantation. Case presentation: We report the case of a 47-year-old multiparous woman with PPCM diagnosed during late pregnancy, who developed severe left ventricular dysfunction complicated by thromboembolic stroke and malignant arrhythmias. Despite optimal guideline-directed medical therapy and cardiac resynchronization therapy with defibrillator (CRT-D), she progressed to refractory NYHA class IV heart failure and was listed for heart transplantation. Conclusion: PPCM may evolve toward advanced heart failure despite optimized treatment. Early recognition, multidisciplinary care, and timely referral for advanced therapies including mechanical circulatory support and heart transplantation are essential in refractory cases.