A CASE OF POST-CAESAREAN PULMONARY OEDEMA DUE TO ASYMPTOMATIC UNDIAGNOSED HEART DISEASE

Post-Caesarean Pulmonary Oedema

Abstract

INTRODUCTION

Cardiac disease especially the one involving the valves is associated with high incidence of decompensation during pregnancy. Valvular heart disease is usually a sequel of rheumatic fever whose incidence is still quite high in Pakistan in contrast to many developed countries of the world where congenital heart disease is now more prevalent¹. Physiologically in pregnancy, plasma expansion starts early and reaches its peak at around 32 weeks. In addition red blood cell mass and cardiac output also increase. However, patients with mild valvular heart disease may stay asymptomatic in early pregnancy. As the pregnancy progresses, most of the patients with valvular heart disease would develop features of cardiac disease due to the haemodynamic burden of pregnancy². In such patients pregnancy continues to be a challenge for the treating doctors as well as patients and it could be associated with unfavourable maternal/ fetal outcomes³. Literacy, sociocultural behavior and lack of awareness regarding medical health, lead to ignorance about the impact of cardiac disease.