cardiac and thrombotic complications in the peripartum period of a patient affected by beta...

Cardiac and thrombotic complications in the peripartum period of a patient affected

by beta-thalassemia intermediaG. Binaghi1, GM. Argiolas2, D. Congia1, C. Dessi3, G. Matta2, S. Mura4,

A. Pani1, D. Pasqualucci1, E. Serra1, M. Porcu1

(1) G. Brotzu Hospital, Department of Cardiology, Cagliari, Italy

(2) G. Brotzu Hospital, Department of Radiology, Cagliari, Italy

(3) Microcitemico Hospital, Thalassemic Day Hospital, Cagliari, Italy

(4) G. Brotzu Hospital, Department of Obstetrics & Gynaecology, Cagliari, Italy

• Female, 32 y-o• Β-thalassemia in regular

transfusion regimen (2009)• Incostant ICT• HCV positive• Splenectomy (2006)

• 05.2013: IVF STOP ICT

• RBC transfusion (each 2w)

• Last cardiac T2*: 32 ms (2009)

• ECG & echo normals at 21w

At 33 week:• Foetal growth restriction Caesar section• Transitory SBP < 90 mmHg & Clinical signs of AHF

(HR: 130/min; T3; Peripheral oedema; BNP: 3790 pg/ml)

• LVEF ≈ 25%

CCU & AHF treatment

T2* basal echo time T2* final echo time

Region Of Interest (ROI) used to evaluate T2*

relaxation times

Colour parametric T2* map showing

abnormal values in Mid-SeptumROI: 10,4 ms

Echocardio:

H: LVEF ≈ 25%Dis: LVEF: 42%6M: LVEF ≈ 55%

Abdominal pain

Echo VTE

Conclusions & Learning Points• More than 500 pregnancies reported in BT pts• Rate of pregnancy of 27.3% (TCRN, 2013)

• B-TI prob. of pregnancy vs prob. in HCV +• B-TI High rate of TE events: 3.3-29%• Cardiac complications: 1.1-15.6%• Peripartum LV dysfunction only 1.5%

Close follow-up of these patients!!!Especially during pregnancy