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?