Secundum Atrial Septal Defect Severe Pulmonary Hypertension in Pregnancy: A Case Report

DOI

10.2991/978-94-6463-048-0_35How to use a DOI?

Keywords

Atrial septal defect; pulmonary hypertension; congenital heart disease; surgical closure

Abstract

Atrial septal defect (ASD) is the most common form of congenital heart disease. Left-to-right shunting leads to right ventricular (RV) volume overload with excessive pulmonary blood flow. In the absence of pulmonary hypertension, pregnancy is generally well tolerated in the setting of an ASD. This case report aimed to describe the features and the multidisciplinary approach management in secundum ASD, severe pulmonary hypertension in pregnancy. A 31 years old woman, pregnant with her second child at 35 weeks gestational age came with a primary complaint of increased shortness of breath a day before being admitted to the hospital. Three months before being admitted to the hospital she complained of shortness of breath when walking ± 20 m. The complaint was felt when her pregnancy was 23 weeks. The shortness of breath got worse with increasing gestational age. She suspected she had a heart problem. The first child was born in 2013, 33 weeks gestational age, spontaneously, weighing 1400 g. Specific examination revealed a pan systolic murmur, maximum punctum ICS 2–3 left parasternal, grade 5/6, spreading medially, wide fixed splitting S2. Echocardiography found right atrial dilatation, interatrial septal defect left to right shunt, severe tricuspid regurgitation, severe pulmonary hypertension, and ejection fraction 73%. The patient had pregnancy termination, right heart catheterization and surgical closure. The patient has clinical improvement without any complications. In conclusion, pregnancy remains contraindicated in patients with ASDs associated with severe pulmonary hypertension due to poor maternal and fetal outcomes. Cardiology follow up during pregnancy should be adapted to clinical symptoms. Pulmonary hypertension associated with an ASD is associated with high morbidity and mortality. Patients should be monitored closely and specialized by a multidisciplinary team approach to achieve optimum outcomes.

Copyright

© 2023 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

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TY  - CONF
AU  - Welly Oktaviandani
AU  - Nuswil Bernolian
AU  - Imran Soleh
AU  - Andi Wahyudi
AU  - Ahmat Umar
AU  - Ali Ghanie
AU  - Fredi Heru Irwanto
AU  - Erwin Sukandi
AU  - Taufik Indrajaya
PY  - 2022
DA  - 2022/12/19
TI  - Secundum Atrial Septal Defect Severe Pulmonary Hypertension in Pregnancy: A Case Report
BT  - Proceedings of the 3rd International Conference on Cardiovascular Diseases (ICCvD 2021)
PB  - Atlantis Press
SP  - 308
EP  - 314
SN  - 2468-5739
UR  - https://doi.org/10.2991/978-94-6463-048-0_35
DO  - 10.2991/978-94-6463-048-0_35
ID  - Oktaviandani2022
ER  -