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Unusual presentation of more common disease/injury
Case report
Management of a parturient with uncorrected tetralogy of Fallot in shock: an anesthetic challenge
  1. Snigdha Bellapukonda1,
  2. Bhim Raju Roncall1,2 and
  3. Manisha Mund1
  1. 1Anaesthesia, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
  2. 2Anaesthesia, Sunshine Hospital, Bhubaneswar, Odisha, India
  1. Correspondence to Dr Bhim Raju Roncall; rbrajumbbs84{at}gmail.com

Abstract

Tetralogy of Fallot (TOF) is the most common form of cyanotic congenital heart disease. The survival of patients with uncorrected TOF till the fourth decade of life is rare (around 3%). Pregnancy in a patient with uncorrected TOF requires a multidisciplinary approach. A confluence of pregnancy, uncorrected TOF and shock is infrequent. The state of hypovolaemia and a decrease in systemic vascular resistance due to anaesthetic agents increase the right to left shunt. The decrease in pulmonary blood flow provokes a ‘hypercyanotic spell’. We report the successful management of 30-year-old pregnant (G3P2A2L0) with uncorrected TOF, presenting to the emergency department with incomplete abortion in shock.

  • anaesthesia
  • cardiovascular medicine
  • obstetrics, gynaecology and fertility

http://dx.doi.org/10.1136/bcr-2019-231517

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    Footnotes

    • Contributors SB, BRR and MM contributed to the design and conception.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.