Case Report: Anesthetic Management for A Pregnant Patient with Pulmonary Hypertension and Eisenmenger Syndrome
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Abstract
Pregnancy in women with heart disease is associated with a higher risk of deterioration of the mother's cardiac status and adverse pregnancy outcomes, including complications such as arrhythmias, premature birth, fetal growth restriction, and a significant risk of maternal and fetal mortality. Few heart conditions pose a massive risk to the mother's life; these include Eisenmenger syndrome, pulmonary hypertension with right ventricular dysfunction, and Marfan syndrome.
We present the case of a 34-year-old female patient with a history of congenital heart disease and Eisenmenger syndrome of 13 years' duration without medical treatment. She presented to the emergency department at 38 weeks' gestation with dyspnea on mild exertion, perioral cyanosis, arrhythmic heart sounds, a hyperdynamic precordium, and diastolic tricuspid and pulmonic murmurs. An emergency cesarean section was performed, resulting in termination of the pregnancy. with anesthetic management with fractional epidural block without success changing anesthetic technique to balanced general anesthesia, discharged patient to ICU orointubated, coupled to mechanical ventilator, without vasopressor support at the time, where she presents a torpid evolution requiring vasopressors without success, until death.
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