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Acute Pulmonary Edema in a Pregnant Patient with Undiagnosed Levo-Transposition of the Great Arteries

Challenging differential diagnosis

Kunal Karamchandani, Jacob Benrud, John T. Swick

USA Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA

Am J Case Rep 2018; 19:1445-1448

DOI: 10.12659/AJCR.912168

Available online:

Published: 2018-12-06


#912168

BACKGROUND: Levo-transposition of the great arteries (L-TGA) is a rare form of congenital heart disease that may go unrecognized until adulthood. Parturient women with L-TGA have a high likelihood of developing acute pulmonary edema and cardiac dysrhythmias during the peri-partum period.
CASE REPORT: We present the case of a 32-year-old primigravida patient with previously unknown diagnosis of L-TGA, presenting with preeclampsia, whose peri-partum course was complicated by the development of acute pulmonary edema, complete heart block, and acute hypoxic respiratory failure.
CONCLUSIONS: This case report highlights the predisposition of parturient women with undiagnosed congenital heart disease to develop acute hypoxic respiratory failure in the perioperative period and the importance of meticulous fluid management in such patients.

Keywords: Heart Defects, Congenital, Heart Failure, Pregnancy Complications, Cardiovascular



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