Percutaneous Transvenóus. Mitral Commissurotomy In A Pregnant Adolescent At AFIC/NJHD

Abstract

A seventeen and a half year old, expectant mother, primigravida, at eighteen weeks gestation, was brought to AFIC/NIHD, with complaints of acute shortness of breath, NYHA Class IV.

Discussion:
Mitral stenosis is the most common rheumatic heart disease in pregnancy’. Pregnancy is associated with a 40% mcrease m circulating blood volume, an increased sympathetic activity and an increase in heart rate2. When mitral stenosis complicates pregnancy. the pressure gradient across the narrow mitral valve increases greatly as left ventricular diastolic filling time decreases secondary to the physiological increase in heart rate and increased cardiac output of pregnancy3. An increased LA pressure and arrhythmogenic effect of pregnancy may result in atrial flutter or fibrillation. substantially accelerating the ventricular rate and further elevating the LA pressure thus predisposing to pulmonary oedema4. These patients usually suffer from various NYHA classes of congestive failure.