Anesthetic challenges in a pregnant patient with post mitral valve replacement, complete heart block, and coagulopathy coming for emergency cesarean section: A case report

A 24-year-old primigravida with a history of rheumatic heart disease and prosthetic mitral valve on oral anticoagulation who was lost follow-up during the third trimester presented with premature rupture of membranes. On evaluation, she had new-onset complete heart block. She was temporarily paced b...

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Bibliographic Details
Published in:Saudi journal of anaesthesia 2019-07, Vol.13 (3), p.237-239
Main Authors: Vijayakumar, Vinodhadevi, Santhoshini, Thiruvarul, Govindarajulu, Dhanabagyam, Mushahida, Shaik
Format: Article
Language:English
Subjects:
Anticoagulants
Arrhythmia
Cardiovascular disease
Cardiovascular diseases
Case Report
Case reports
Catheters
Central nervous system agents
Cesarean delivery
coagulopathy
complete heart block
parturient
prosthetic mitral valve
warfarin
Cesarean section
Consent
Endocarditis
Heart
Heart block
Heart diseases
Heart failure
Patients
Physiology
Pregnancy
Pregnant women
Premature rupture of the membrane
Prostheses
Prostheses and implants
Pulmonary arteries
Rheumatic heart disease
Succinylcholine
Veins & arteries
Warfarin
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Summary:A 24-year-old primigravida with a history of rheumatic heart disease and prosthetic mitral valve on oral anticoagulation who was lost follow-up during the third trimester presented with premature rupture of membranes. On evaluation, she had new-onset complete heart block. She was temporarily paced but developed cardiac failure. Anesthetic challenges and management of this parturient with post mitral valve replacement, complete heart block, and warfarin-induced coagulopathy for emergency cesarean delivery are discussed in this case report. Ours is the first case report of a pregnant patient with new onset of complete heart block during pregnancy several years after mitral valve replacement.
ISSN:1658-354X
0975-3125
DOI:10.4103/sja.SJA_781_18