Work

Severe Aortic Valve Stenosis During Pregnancy

Year: 2025

Type: article

Abstract: BACKGROUND: Pregnant women with underlying cardiovascular disease are at an increased risk of maternal-fetal morbidity and mortality especially in the setting of symptomatic stenotic valvular heart disease. CASE SUMMARY: A 35-year-old female at 17 weeks gestation presented to the emergency department with exertional dyspnea for 3 months and was diagnosed with decompensated heart failure. Echocardiogram demonstrated left ventricular ejection fraction of 45% with severe aortic valve stenosis and moderate aortic regurgitation. A multidisciplinary pregnancy heart team recommended urgent surgical aortic valve replacement prior to fetal maturity. DISCUSSION: Hemodynamic changes in pregnancy, such as increased blood volume and heart rate, may unmask asymptomatic cardiovascular disease. Specifically, increased blood volume during pregnancy is poorly tolerated in patients with stenotic valvular disease and may result in NYHA functional class III or IV heart failure. TAKE-HOME MESSAGE: Cardiovascular comorbidities in pregnant women require careful evaluation by a multidisciplinary pregnancy heart team to determine optimal timing and approach for intervention.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.104453

Authors: Lindsay A. Gallagher, Shuo Li, Zeynep Alpay Savasan, Thomas Schwann, Saavia S. Girgla

Institutions: Oakland University, Beaumont Hospital, Royal Oak, Corewell Health William Beaumont University Hospital

Language: English

Topic: Cardiovascular Issues in Pregnancy

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850