A 29-year-old female G1P1 who is currently contemplating pregnancy but had history of permpartum cardiomyopathy/HF with improved (LVEF 30% in early 2019 >> improved to 50% @ the end of 2019 ).
3 months postpartum in early 2019, reported dyspnea with leg swelling with echo showed LVEF 30%. Improved with medical management and currently NYHA class I with recent echo showed LVEF 50%. On losartan, spironolactone and carvedilol.
She is willing to take risk even if she ended up in cariogenic shock requiring mechanical circulatory support.
I want to hear other members opinion how to approach the case during pregnancy and postpartum as well.
Would you support frequent echos? No lactation?
Below is link to the presentation of Dr. Adel Dyub (note that Youtube labeled it as special access as it contains some videos of surgery which is appropriate for adults):
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