PERIPARTUM CARDIOMYOPATHY AND ANAESTHESIA: Author's Reply

• 1.Non-specific ST & T changes may be common ECG finding in dilated cardiomyopathies. However in this particular case, the patient showed clear clinical features of LVF and ECG findings were typical of LVH with strain pattern i.e. depressed ST segment and inverted T waves. This patient did not give any history of hypertensive heart disease prior to present pregnancy. Her previous pregnancies and deliveries were uncomplicated. However, I agree that echocardiography findings were suggestive of dilated cardiomyopathy.
• 2.I also agree with the writer that chest radiograph findings were those of pulmonary venous hypertension.
• 3.As the patient showed signs of congestive heart failure with marked tachycardia and poor myocardial contractility, she was digitalised to improve cardiac output, to reduce mismatch and to improve oxygen delivery to tissues. As the plan was to take up the patient for LSCS at the earliest to save the mother as well as the baby, initial trial with vasodilators and diuretics would have perhaps delayed this life saving operation with unfavourable outcome.