Pregnant woman with Ebstein’s anomaly
Full Text:
Abstract
A 34-year-old female with Ebstein’s anomaly presented to our centre at 19th week of her fi rst pregnancy with a history of dyspnea, palpitations and syncopes. Echocardiogram showed typical signs of Ebstein’s anomaly with severe tricuspid regurgitation, large atrial septal defect with left-to-right shunt and elevated right ventricular systolic pressure. She was prescribed metoprolol and anticoagulation with low-molecular-weight heparin. The pregnancy course was uneventful. She delivered by vaginal route in 36th week of pregnancy a healthy male baby weighing 2140 g. On the 6th day after delivery she experienced tachycardia, dyspnea, dizziness. Clinical examination and additional studies revealed only slight limb oedema
and low haemoglobin level. After treatment with furosemide and prescription of folic acid and iron supplementation she was discharged home in a good clinical condition after 4 days. JRCD 2012; 1: 13–17
Key words: Tricuspid valve regurgitation; Atrial septal defect; Pulmonary hypertension
References
Attenhofer Jost CH, Connolly HM, et al. Ebstein’s anomaly: review of a multi-faceted congenital cardiac condition. Swiss Med Wkly 2005; 135: 269–281.
Kapusta L, Eveleigh RM, Poulino SE, et al. Ebstein’s anomaly: factors associated with death in childhood and adolescence: a multi-centre, long-term study. Eur Heart J 2007; 28: 2661–2666.
Giulani R, Fuster V, Brandenburg RO, Mair DD. Ebstein’s anomaly: the clinical features and natural history of Ebstein’s anomaly of the tricuspid valve. Mayo Clin Proc 1979; 54: 163–173.
Connolly H, Warnes CA. Ebstein’s anomaly: outcome of pregnancy. J Am Coll Cardiol 1994; 23: 1194 –1198.
Chopra S, Suri V, Aggarwal N, et al. Ebstein’s anomaly in pregnancy: Maternal and neonatal outcomes. J Obstet Gynaecol Res 2010; 36: 278–283.
Zielinsky P, Pilla CB. Ebstein’s anomaly with imperforate tricuspid valve. Prenatatal diagnosis. Arq Bras Cardiol 2000; 75: 43–45.
Gultekin F, Baskin E, Gokalp A, Dogan K. A pregnant woman with Ebstein’s anomaly. A case report. Mater Med Pol 1994; 26: 149–151.
Celermajer DS, Bull C, Till JA, et al. Ebstein’s anomaly: presentation and out-come from fetus to adult. J Am Coll Cardiol 1994; 23: 170–176.
Attenhofer CH, Connolly HM, Dearani J, et al. Ebstein’s anomaly. Circulation 2007; 115: 277–285.
MacLellan – Tobert SG, Driscoll DJ, Mottram CD, et al. Exercise tolerance in patients with Ebstein’s anomaly. J Am Coll Cardiol 1997; 29: 1615–1622.
Driscoll DJ, Mottram CD, Danielson GK. Spectrum of exercise intolerance in 45 patients with Ebstein’s anomaly and observations on exercise tolerance in 11 patients after surgical repair. J Am Coll Cardiol 1988; 11: 831–836.
Edwards WD. Embryology and pathologic features of Ebstein’a anomaly. Prog Pediatr Cardiol 1993; 2: 5–15.
Carpentier A, Chauvaud S, Mace L, et al. A new reconstructive operation for Ebstein’s anomaly of the tricuspid valve. J Thorac Cardiovasc Surg. 1988; 96: 92–101.
Paranon S, Acar P. Congenital heart disease: Ebstein’s anomaly of the tricuspid valve: from fetus to adult. Heart 2008; 94: 237–243.
Danielson GK, Driscoll DJ, Mair DD, et al. Operative treatment of Ebstein’s anomaly. J Thorac Cardiovasc Surg. 1992; 104: 1195–1202.
Brickner ME, Hillis LD, Lange RA. Congenital heart disease in adults: second of two parts. N Engl J Med. 2000; 342: 334–342.
Hebe J. Ebstein’s anomaly in adults: arrhythmias: diagnostic and therapeutic approach. Thorac Cardiovasc Surg. 2000: 48: 214–219.
Ho SY, Goltz D, McCarthy K, et al. The atrioventricular junctions in Ebstein malformation. Heart 2000; 83: 444–449.
Attenhofer Jost CH, Connolly HM, Warnes CA, et al. Noncompacted myocardium in Ebstein’s anomaly: initial description in three patients. J Am Soc Echocardiogr. 2004; 17: 677–680.
Dearani JA, Danielson GK. Congenital Heart Surgery Nomenclature and Database Project: Ebstein’s anomaly and tricuspid valve disease. Ann Thorac Surg. 2000; 69 (4 Suppl): 106–117.
The Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC) et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy. Eur Heart J 2011; 32: 3147–3197.
Donnelly JE, Brown JM, Radford DJ. Pregnancy outcome and Ebstein’s anomaly. Br Heart J 1991; 66: 368–371.
Parambil JG, McGoon MD. Pregnancy and pulmonary hypertension. W: Heart disease in pregnancy. Oakley C and Warnes CA. Blackwell Publishing, 2nd ed 2007, pp. 59–78.
Waickman LA, Skorton DJ, Varner MW, et al. Ebstein’s anomaly and pregnancy. Am J Cardiol 1984; 53: 357
Shiina A, Seward JB, Edwards WD, et al. Two-dimensional echocardiographic spectrum of Ebstein’s anomaly: detailed anatomic assessment. J Am Coll Cardiol 1984; 3: 356–370.
Nataloni M, Mocchegiani R. Ebstein’s anomaly and pregnancy: a case report. Ital Heart J 2004; 5: 707–710.
Macfarlane AJ, Moise S, Smith D. Caesarean section using total intravenous anaesthesia in a patient with Ebstein’s anomaly complicated by supraven-tricular tachycardia. Int J Obstet Anesth 2007; 16: 155–159.
Chatterjee S, Sengupta I, Mandal R, et al. Anaesthetic management of caesarean section in a patient with Ebstein’s anomaly. Indian J Anaesthesia 2008; 52: 321–323.
Misa VS, Pan PH. Evidence-based case report for analgesic and anesthetic management of a parturient with Ebstein’s anomaly and Wolff–Parkinson–White syndrome. Int J Obstet Anaesth 2007; 16: 77–81.
Groves ER, Groves BJ. Epidural analgesia for labour in a patient with Ebstein’s anomaly. Can J Anaesth 1995; 42: 77–79.
Drenthen W, Pieper PG, Roos-Hesselink JW, et al. Outcome of pregnancy in women with congenital heart disease: a literature review. J Am Coll Cardiol 2007; 49: 2303.
Habib G, Hoen B, Tornos P, et al. Guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009): the Task Force on the Prevention, Diagnosis, and Treatment of Infective Endocarditis of the European Society of Cardiology (ESC). Eur Heart J 2009; 30
DOI: http://dx.doi.org/10.20418%2Fjrcd.vol1no1.24
Refbacks
- There are currently no refbacks.