Casey Gould’s labor turned life-threatening when she told medical staff she felt she was about to die, moments before her heart failed.
The 33-year-old had experienced an uncomplicated pregnancy after years of infertility struggles and three miscarriages. She went into labor on November 1, 2024 and after a 36-hour labor, she was ready to push. Despite normal vitals and pain control from an epidural, Gould suddenly experienced a overwhelming sense of dread, saw what she described as black shadows in the corners of the room, and urgently told her doctor and a nurse, “I think I’m about to die.”
Immediately after her statement, her son’s heart rate dropped, prompting an emergency C-section. Gould was sedated and rushed to surgery. Once her son was delivered, doctors discovered her heart was failing, with an ejection fraction of just 13% — far below the normal range of 55% to 70%. Cardiologist Dr. Amer Sayed placed an Impella pump via her femoral artery to support her heart function. Gould remained in a coma on a ventilator for two days in the cardiac ICU before gradually recovering.
How peripartum cardiomyopathy presents in otherwise healthy patients
Gould’s symptoms align with peripartum cardiomyopathy, a rare form of heart failure that occurs late in pregnancy or shortly after delivery. It often strikes women with no prior heart disease, making it difficult to anticipate. The condition causes the heart muscle to weaken, reducing its ability to pump blood, and can progress rapidly to cardiogenic shock if not treated promptly.
Last time a similar case gained attention, a 2022 study in the Journal of the American Heart Association noted that delayed recognition of symptoms like shortness of breath and fatigue contributed to worse outcomes, underscoring the importance of maternal vigilance and clinician awareness during the peripartum period.
What recovery and long-term monitoring involve
After regaining consciousness, Gould had no memory of the cardiac event and initially believed she had suffered a hemorrhage during surgery. Medical staff later explained the severity of her condition. She continues to follow up with cardiologists, as recovery of heart function varies — some patients regain normal ejection fraction, while others may require long-term device support or transplantation.
The Impella pump, used temporarily in Gould’s case, is designed to unload the left ventricle and maintain blood flow during acute heart failure. Its use in peripartum cardiomyopathy has increased in recent years as a bridge to recovery, though decisions depend on individual response and hemodynamic stability.
What is peripartum cardiomyopathy?
Peripartum cardiomyopathy is a type of heart failure that occurs in the final month of pregnancy or up to five months after delivery, characterized by weakened heart muscle and reduced pumping ability in the absence of other identifiable causes.
How common is this condition?
It affects approximately 1 in 1,000 to 4,000 pregnancies in the United States, with higher risk in women over 30, those with multiple pregnancies, and individuals with preeclampsia or gestational hypertension.
