A 40-year-old female G4P4L3A1 who gave bih to her third child 1 month ago presented with recent onset of cough and palpitations associated with paroxysmal nocturnal dyspnea, ohopnea and exeional intolerance. Patient also complained of a few episodes of hemoptysis 2 days back. Patient also had a history of pre-eclampsia in her last pregnancy. O/E, JVP- increased Crepts in B/L basal lung fields along Shift of the apical impulse ECHO studies showed left ventricular ejection fraction < 45%. Patient was given treatment for the same but the patient didn't survive. HPE examination was done from autopsied hea. THE gross specimen of the hea is shown below. Which finding would be most likely present on HPE examination: -
High-Yield Explanation
This is a case of peripaum cardiomyopathy. Gross specimen of hea shows massive left ventricular dilation and moderate right ventricular dilation Peripaum cardiomyopathy (PPCM) develops during the last trimester or within the first 6 months after pregnancy. Risk factors are: - Increased maternal age Increased parity Twin pregnancy Malnutrition Use of tocolytic therapy for premature labor Preeclampsia or toxemia of pregnancy. Lymphocytic myocarditis has sometimes been found on myocardial biopsy.