Perioperative Management Challenges and Cardiac Arrest in Termination of Pregnancy for Severe Rheumatic Valvular Heart Disease: A Case Report
DOI:
https://doi.org/10.63682/jns.v14i17S.4517Keywords:
Curretage, Anesthesia Procedure, Valvular Heart Disease, Rheumatic Heart DiseaseAbstract
Pregnancy termination in patients with valvular heart disease carries significant risks, particularly during curettage. This case report describes a 35-year-old woman with severe rheumatic heart disease, including mitral stenosis, regurgitation, and atrial fibrillation. At 10 weeks gestation, she experienced intrauterine fetal demise, and a curettage with sterilization was performed under general anesthesia. The procedure was complicated by a vasovagal reaction causing cardiac arrest, requiring CPR and ICU care. Despite successful resuscitation, the patient needed intensive management for persistent atrial fibrillation, including cardioversion and medications. This case emphasizes the need for meticulous perioperative planning, multidisciplinary care, and close monitoring in high-risk patients to prevent complications and ensure favorable outcomes. Future research should focus on optimizing care protocols for these patients
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Goland S, Bitar F, Modi K, Safirstein J, Ro A, Mirocha J, et al. Evaluation of the clinical relevance of baseline left ventricular ejection fraction as a predictor of recovery or persistence of severe dysfunction in women in the United States with peripartum cardiomyopathy. J Card Fail. 2011;17(5):426–30.
Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, Blomström-Lundqvist C, Cifkova R, De Bonis M, et al. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy: the task force for the management of cardiovascular diseases during pregnancy of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(34):3165–241.
Siu SC, Sermer M, Colman JM, Alvarez AN, Mercier LA, Morton BC, et al. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation. 2001;104(5):515–21.
Elkayam U, Goland S, Pieper PG, Silversides CK. High-risk cardiac disease in pregnancy: part I. J Am Coll Cardiol. 2016;68(4):396–410.
Sahni G, Elkayam U. Cardiovascular Disease in Pregnancy, An Issue of Cardiology Clinics. Vol. 30. Elsevier Health Sciences; 2012.
DT M. Anesthesia for the pregnant cardiac patient. Shnider and Levinson’s anesthesia for obstetrics. 2002;
Clark SL, Belfort MA, Dildy GA, Herbst MA, Meyers JA, Hankins GD. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol. 2008;199(1):36-e1.
Sliwa K, Johnson MR, Zilla P, Roos-Hesselink JW. Management of valvular disease in pregnancy: a global perspective. Eur Heart J. 2015;36(18):1078–89
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