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

Abstract

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.

Keywords

• Cesarean delivery; coagulopathy; complete heart block; parturient; prosthetic mitral valve; warfarin