Anesthetic management in a patient with mitral stenosis associated with pregnancy induced hypertension

Abstract

Patients with mitral stenosis associated with Pregnancy Induced Hypertension (PIH) continue to pose
a challenge to anesthesiologist and could be associated with an unfavorable maternal as well as fetal
outcome. Women with mitral stenosis often do not tolerate the cardiovascular demands of pregnancy.
This increased volume load and tachycardia together cause the patients to deteriorate and advance from
one New York Heart association (NYHA) class to another. We report a, 28 year female, who underwent
cesarean section under combined spinal-epidural anesthesia (CSEA). The uneventful course of the
anesthesia in the presented case was due to the thorough systemic evaluation and careful anesthetic
strategy.