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

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

4. • 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

5. 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

6. 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