Peripartum cardiomyopathy is a rare life threatening cause of dilated cardiomyopathy in parturients. The major concern for anaesthesiologists while managing these patients is to avoid myocardial depression and maintain stable hemodynamics perioperatively.

We report a case of 26year old primigravida of 36 weeks gestation with peripartum cardiomyopathy for emergency caeserian section. She presented with history of grade IV dyspnea, anasarca and weight gain of more than 10kgs in last trimester of pregnancy. On examination her vitals were HR-112/min,BP-130/100mmhg,bilateral pitting edema present. On auscultation – S1 and S2 were heard, bilateral basal crepitations present. Her ECHO revealed- global hypokinesia of LV, EF of 0.34, moderate lv systolic dysfunction, dilated LV(5.4CM), moderate MR, jet area 5.7 cm2, mild TR, mild PAH. She was started on IV furosemide and labetalol. she was shifted to OR for emergency LSCS. The plan of anaesthesia was graded epidural. she was placed in left lateral position and placed epidural catheter in L3-L4 intervertebral space. An episode of hypotension was managed with IV phenylephrine. Rest of intraoperative period was uneventful. Patient was shifted to PACU. she was adviced IV furosemide and epidural analgesia with fentanyl @ 20mcg/hr and restriction of IV fluids. She developed dyspnea with b/l diffuse crepitations and increased pedal edema . Immediately O2 supplementation and IV MANNITOL 50ml stat was given. She was treated until symptoms subsided. Rest of postoperative period was managed with diuretics and betablockers.post op EF -39%&Weight loss OF 30 kgs was noted.