A pregnant woman with a mechanical prosthetic valve

A 24-year-old woman who was 11 weeks pregnant and had a mechanical mitral valve presented at the emergency department with ischemic stroke. Although treatment with aspirin and unfractionated heparin was initially successful, subsequent management was almost impossible, as she eventually suffered a r...

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Main Authors:	Gonçalo J. Morgado, Inês R. Cruz, Ana Catarina Gomes, Ana Rita Almeida, Maria José Loureiro, Carlos Cotrim, Hélder Pereira
Format:	Article
Language:	English
Published:	Elsevier 2019-06-01
Series:	Revista Portuguesa de Cardiologia
Online Access:	http://www.sciencedirect.com/science/article/pii/S0870255117301920

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spelling	doaj-518a294741684104982efd5ac54b076e2020-11-25T02:19:43ZengElsevierRevista Portuguesa de Cardiologia0870-25512019-06-01386457.e1457.e3A pregnant woman with a mechanical prosthetic valveGonçalo J. Morgado0Inês R. Cruz1Ana Catarina Gomes2Ana Rita Almeida3Maria José Loureiro4Carlos Cotrim5Hélder Pereira6Hospital Garcia de Orta, Almada, Portugal; Corresponding author.Hospital Garcia de Orta, Almada, PortugalHospital Garcia de Orta, Almada, PortugalHospital Garcia de Orta, Almada, PortugalHospital Garcia de Orta, Almada, PortugalHospital da Cruz Vermelha Portuguesa, Lisboa, PortugalHospital Garcia de Orta, Almada, PortugalA 24-year-old woman who was 11 weeks pregnant and had a mechanical mitral valve presented at the emergency department with ischemic stroke. Although treatment with aspirin and unfractionated heparin was initially successful, subsequent management was almost impossible, as she eventually suffered a right hemispheric stroke, requiring percutaneous intervention and an emergency cesarian; prosthetic valve thrombosis with hemodynamic instability; and multiple bleeding complications. This case demonstrates how difficult it can be to select the appropriate treatment strategy for prosthetic valve thrombosis. Resumo: Uma mulher de 24 anos, grávida de 11 semanas, com uma prótese mecânica em posição mitral, foi admitida no serviço de urgência com um acidente vascular cerebral isquémico. Apesar de a terapêutica com aspirina e heparina não fracionada ter sido inicialmente bem-sucedida, a gestão subsequente da doente foi dificultada por várias intercorrências: acidente vascular cerebral hemisférico direito com necessidade de intervenção percutânea e realização de cesariana emergente; trombose obstrutiva de prótese com instabilidade hemodinâmica; múltiplas complicações hemorrágicas. Este caso permite ilustrar as dificuldades na seleção do tratamento da trombose de prótese. Keywords: Pregnancy and cardiovascular disease, Embolism and thrombosis, Heart valve prosthesis, Palavras-chave: Gravidez e doença cardiovascular, Trombose e embolia, Prótese valvular cardíacahttp://www.sciencedirect.com/science/article/pii/S0870255117301920
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Gonçalo J. Morgado Inês R. Cruz Ana Catarina Gomes Ana Rita Almeida Maria José Loureiro Carlos Cotrim Hélder Pereira
spellingShingle	Gonçalo J. Morgado Inês R. Cruz Ana Catarina Gomes Ana Rita Almeida Maria José Loureiro Carlos Cotrim Hélder Pereira A pregnant woman with a mechanical prosthetic valve Revista Portuguesa de Cardiologia
author_facet	Gonçalo J. Morgado Inês R. Cruz Ana Catarina Gomes Ana Rita Almeida Maria José Loureiro Carlos Cotrim Hélder Pereira
author_sort	Gonçalo J. Morgado
title	A pregnant woman with a mechanical prosthetic valve
title_short	A pregnant woman with a mechanical prosthetic valve
title_full	A pregnant woman with a mechanical prosthetic valve
title_fullStr	A pregnant woman with a mechanical prosthetic valve
title_full_unstemmed	A pregnant woman with a mechanical prosthetic valve
title_sort	pregnant woman with a mechanical prosthetic valve
publisher	Elsevier
series	Revista Portuguesa de Cardiologia
issn	0870-2551
publishDate	2019-06-01
description	A 24-year-old woman who was 11 weeks pregnant and had a mechanical mitral valve presented at the emergency department with ischemic stroke. Although treatment with aspirin and unfractionated heparin was initially successful, subsequent management was almost impossible, as she eventually suffered a right hemispheric stroke, requiring percutaneous intervention and an emergency cesarian; prosthetic valve thrombosis with hemodynamic instability; and multiple bleeding complications. This case demonstrates how difficult it can be to select the appropriate treatment strategy for prosthetic valve thrombosis. Resumo: Uma mulher de 24 anos, grávida de 11 semanas, com uma prótese mecânica em posição mitral, foi admitida no serviço de urgência com um acidente vascular cerebral isquémico. Apesar de a terapêutica com aspirina e heparina não fracionada ter sido inicialmente bem-sucedida, a gestão subsequente da doente foi dificultada por várias intercorrências: acidente vascular cerebral hemisférico direito com necessidade de intervenção percutânea e realização de cesariana emergente; trombose obstrutiva de prótese com instabilidade hemodinâmica; múltiplas complicações hemorrágicas. Este caso permite ilustrar as dificuldades na seleção do tratamento da trombose de prótese. Keywords: Pregnancy and cardiovascular disease, Embolism and thrombosis, Heart valve prosthesis, Palavras-chave: Gravidez e doença cardiovascular, Trombose e embolia, Prótese valvular cardíaca
url	http://www.sciencedirect.com/science/article/pii/S0870255117301920
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A pregnant woman with a mechanical prosthetic valve

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