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Journal of Obstrectic Anaesthesia and Critical Care
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CASE REPORT
Year : 2022  |  Volume : 12  |  Issue : 1  |  Page : 74-77

Anaesthetic management of a patient with sub-valvular aortic stenosis for emergency lower segment caesarean section: A case report


1 Department of Anaesthesia, Fortis Hospital, Mulund, Mumbai, Maharashtra, India
2 Department of Obstetrics and Gynaecology, Fortis Hospital, Mulund, Mumbai, Maharashtra, India

Correspondence Address:
Dr. Anita R Chhabra
1603/1604, Marathon Galaxy 1, LBS Road, Mulund (West), Mumbai - 400 080, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JOACC.JOACC_48_21

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Sub-valvular aortic stenosis (SAS) occurs due to a fibrous membrane or a muscular narrowing causing left ventricular outflow tract obstruction. The physiological changes of pregnancy may exacerbate the cardiac condition posing significant challenges for anaesthesia and surgery. A 34 years primigravida, with 32 weeks gestation, a known case of sub-valvular aortic stenosis presented in the emergency room in view of leaking/bleeding per-vagina. Risk factors such as tachycardia, decrease in afterload, preload and increased left ventricle contractility lead to exacerbation of the obstruction and should be avoided. We report a successful anaesthetic management of her lower segment cesarean section while balancing the physiological changes of pregnancy superimposed by pathology of the disease.


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