Cardiovascular disease remains a major cause of both morbidity and mortality during pregnancy and in the peripartum period, despite major advances in the care of such patients. The concept of the cardio-obstetric team has received renewed attention and importance in the 2018 European Society of Cardiology guidelines. We wish to present the following case which demonstrated the utility of multidisciplinary care in complex cardiac patients in terms of achieving excellent maternal and foetal outcomes.
A 38-year-old (G2P1) refugee from Eastern Europe was referred to our cardiology service regarding management of high-risk cardiovascular disease during her pregnancy. Her cardiovascular background was notable for prior history of rheumatic fever, culminating in a mechanical mitral valve replacement at 32 years old. Her background history was also notable for prior venous thromboembolism while taking the combined oral contraceptive pill. Her obstetric history was notable for prior lower segment Caesarean section in 2012 under general anaesthesia prior to her mitral valve replacement. Unfortunately, we were unable to get more specific details regarding prior surgery and transthoracic echocardiogram (TTE) results from her country of birth.
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