Severe mitral valve stenosis diagnosed two days after cesarean section

Micha G1, Stamatakis E1, Pamboucas C2, Valsamidis D1

1Department of Anesthesiology, Alexandra hospital, Athens, Greece
2Department of Clinical Therapeutics, Alexandra hospital, Athens, Greece




We present the case of a 29 year old pregnant woman of Pakistani origin who was admitted into the obstetric clinic due to intrauterine growth retardation, fetal bradycardia and preeclampsia. Preoperative evaluation was negative for any preexisting pathology and emergency cesarean section was consequently decided. The patient could only speak the Pakistani language and no information was accessible due to the absence of a translator. The patient was subjected to general anaesthesia and welve hours postoperatively she presented with orthopnea and concurrent tachycardia. An elementary cardiological evaluation was negative for any signs of pathology and intraabdominal bleeding was ruled out after performing an abdominal ultrasound and paracentesis. The patient was transferred into the HDU where she was subjected to right heart catheterization and cardiac ultrasound which revealed severe mitral valve stenosis with pulmonary hypertension resulting in pulmonary edema. Immigrants comprise a special group of patients due to different culture, language barrier, and their vague health record. 

Key words: mitral stenosis; immigrants; guidelines; cultural mediators