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Cardiac and thrombotic complications in the peripartum period of a patient affected by beta thalassemia intermedia

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Cardiac and thrombotic complications in the peripartum period of a patient affected by beta thalassemia intermedia

  1. 1. Cardiac and thrombotic complications in the peripartum period of a patient affected by beta-thalassemia intermedia G. 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
  2. 2. • 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
  3. 3. 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-Septum ROI: 10,4 ms Echocardio: H: LVEF ≈ 25% Dis: LVEF: 42% 6M: LVEF ≈ 55% Abdominal pain  Echo  VTE
  4. 4. 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

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