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Whooping cough complicating pulmonary hypertension in pregnancy
  1. Tiffany Tuck Chin Wong1,
  2. Yang Huang Grace Ng2,
  3. Limin Yan3 and
  4. Ann Wright2
  1. 1Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore
  2. 2Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
  3. 3Department of Cardiology, National Heart Centre Singapore, Singapore
  1. Correspondence to Dr Tiffany Tuck Chin Wong; tiffany.wong{at}mohh.com.sg

Abstract

We report a case of a previously fit woman who presented at 26 weeks into her fourth pregnancy with a dry cough. Following a nasopharyngeal swab, she was diagnosed with a pertussis infection, and treated with antibiotics. A chest X-ray showed right atrial dilatation and an echocardiogram was scheduled outpatient. However, after re-presenting with worsening cough and dyspnoea, an inpatient echocardiogram was performed which suggested elevated pulmonary pressures with significant tricuspid regurgitation, as confirmed by subsequent cardiac catheterisation. She had an elective caesarean section at 34 weeks and underwent repeat right heart catheterisation which revealed persistent, and likely pre-existing, pulmonary arterial hypertension. This case highlights the importance of thorough assessment of non-obstetric symptoms in pregnancy in formulating alternative differentials, even after a diagnosis has been made, to prevent potentially life-threatening conditions from being missed. It also shows that although often associated, respiratory and cardiac causes may coexist separately.

  • obstetrics and gynaecology
  • pregnancy
  • hypertension

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Footnotes

  • Contributors TTCW contributed to the conception and design of the article, acquisition of data, interpretation of data and writing of the manuscript. YHGN contributed to the conception and design of the article, interpretation of data and editing of the manuscript. LY contributed to the interpretation of data and editing of the manuscript. AW contributed to the conception and design of the article, interpretation of data and editing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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