Vijayakumar Vinodhadevi, Santhoshini Thiruvarul, Govindarajulu Dhanabagyam, Mushahida Shaik
Department of Anesthesiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India.
Saudi J Anaesth. 2019 Jul-Sep;13(3):237-239. doi: 10.4103/sja.SJA_781_18.
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.
一名24岁初产妇，有风湿性心脏病史且植入人工二尖瓣并口服抗凝药，在妊娠晚期失访，现出现胎膜早破。经评估，她新发完全性心脏传导阻滞。她接受了临时起搏，但出现了心力衰竭。本病例报告讨论了该产妇二尖瓣置换术后、完全性心脏传导阻滞以及华法林所致凝血病患者行急诊剖宫产时的麻醉挑战与处理。我们的病例报告是首例二尖瓣置换术后数年妊娠期间新发完全性心脏传导阻滞的孕妇。
