Swollen, Breathless and Hypoxic: Postpartum Pulmonary Hypertension, A Fatal Mimic

Abstract

Background: Pulmonary hypertension (PH), characterized by a mean pulmonary artery pressure (mPAP) exceeding 20 mmHg, is a life-threatening condition that may be misdiagnosed in the postpartum period due to its clinical overlap with peripartum cardiomyopathy and pulmonary embolism. PH poses a particularly high risk of maternal mortality during the puerperium.

Case Summary: We describe a 28-year-old woman, two months postpartum, who presented in World Health Organization (WHO) functional class IV with profound right heart failure, severe hypoxia, hypotension, and anasarca. She was ultimately diagnosed with idiopathic pulmonary hypertension.

Conclusion: A high index of suspicion and prompt recognition of PH are vital for effective management and counseling regarding future pregnancies. To ensure access to appropriate care, governments should consider providing comprehensive insurance coverage for women affected by this high-risk condition.