Abstract

Introduction: Cardio circulatory changes associated with pregnancy may result in a significant hemodynamic burden and can lead to morbidity and even mortality in women with cardiac disease(3). Women with congenital heart disease now comprise the majority of pregnant women with heart disease seen at referral centres(4). in the presence of maternal heart disease, the circulatory changes of pregnancy may result in decompensation or death of the mother or fetus(3).therefore extra attention is needed to be payed in these cases. Case report: A 19-year-old woman with twin pregnancy gravida II para I was complaining at 21 weeks gestation of shortness of breath and dyspnea on exertion. The echocardiogram revealed severe dilatation of right ventricle, mild to moderate TR, mild MR.the patient was taken to CCU for better cardiac monitoring. Discussion: The higher maternal mortality rates may be due to instability of the cardiac status due to advanced cardiac involvement in the disease process. However, good patients’ compliance and the high quality antenatal care provided may have contributed to the lack of maternal mortality in some studies. Mitral valve disease was seen more commonly compared to aortic valve disease in pregnant women in the most studies.Regurgitant valve disease is well tolerated during pregnancy due to the systemic vasodilatation favors forward flow and the left ventricular filling is rapid and unimpeded. The regurgitant flow tends to decrease with the increased cardiac output and fall in the systemic vascular resistance. © 2017, Pharmainfo Publications. All rights reserved.