Pseudo-heart failure in pregnancy complicated by preeclampsia: giant mediastinal teratoma with extrinsic cardiopulmonary compression

Scritto il 12/08/2026
da Jose Lopez Ventosa

BMJ Case Rep. 2026 Aug 12;19(8):e274681. doi: 10.1136/bcr-2026-274681.

ABSTRACT

A woman in her early 20s at 30 weeks of gestation presented with elevated blood pressure, transaminitis, progressive dyspnoea, orthopnoea, exertional chest pain and peripheral oedema, raising concern for preeclampsia-associated cardiopulmonary disease or peripartum cardiomyopathy. Transthoracic echocardiography showed preserved left ventricular systolic function, normal left-sided filling pressures, right ventricular dilatation and an estimated right atrial pressure of 15 mmHg; N-terminal pro-brain natriuretic peptide was 57 pg/mL. Cross-sectional imaging revealed a large multi-cystic anterior mediastinal mass occupying the left hemithorax, displacing the heart and abutting/compressing major cardiopulmonary structures. Labour was induced at 34 weeks after clinical stabilisation. Three months postpartum, the patient re-presented with worsening dyspnoea and haemoptysis and underwent complete surgical resection. Pathology confirmed mature cystic teratoma and cardiopulmonary symptoms resolved after resection.

PMID:42586591 | DOI:10.1136/bcr-2026-274681