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Case Report

Anaesthetic Management of Pregnant Patient with Supraventricular Tachycardia posted for Emergency Caesarean Section

Bharath C J, Suresh Kumar N, Gagan M

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Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

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Indian Journal of Anesthesia and Analgesia 11(4):p 226-229, Oct - Dec. 2024. | DOI: 10.21088/ijaa.2349.8471.11424.10

How Cite This Article:

Bharath CJ, Suresh Kumar N, Gagan M. Anaesthetic management of pregnant patient with supraventricular tachycardia posted for emergency caesarean section. Ind J Anesth Analg. 2024;11(4):226-9.

Timeline

Received : September 16, 2024         Accepted : October 16, 2024          Published : December 20, 2024

Abstract

Introduction: This case report details the anaesthetic management of a pregnant patient with supraventricular tachycardia (SVT) undergoing an emergency caesarean section. SVT, a common arrhythmia in pregnancy, is initially treated with adenosine. When adenosine fails, calcium channel blockers like diltiazem are used, and amiodarone is considered as a third-line option before electrical cardioversion. Case Report: In this case, a 19-year-old primigravida at 40 weeks 4 days presented with palpitations and SVT with a heart rate of 201 bpm despite adenosine and diltiazem. Amiodarone was successfully administered, reducing the heart rate to 143 bpm with visible P waves on ECG. Subsequently, she underwent an emergency caesarean section under spinal anaesthesia with 0.5% bupivacaine and fentanyl. Hypotension following the spinal anaesthesia was managed using phenylephrine and IV fluids, maintaining a stable intraoperative heart rate of 120-130 bpm. Throughout the surgery, phenylephrine was used to prevent hypotension associated sympathetic stimulation, which could exacerbate SVT. Post-operatively, the patient maintained normal sinus rhythm, and after evaluation by a cardiologist and echocardiogram, no significant abnormalities were found. She was discharged after 7 days of postnatal care without recurrence of SVT or other arrhythmias. This case highlights the complexity of managing SVT during pregnancy, necessitating a multidisciplinary approach involving anaesthesiologists and cardiologists. The choice of spinal anaesthesia over general anaesthesia was made based on its minimal cardiovascular impact and effective management of hemodynamic stability with vasoactive medications. Careful consideration of pharmacological interventions and their potential effects on both maternal and fetal health is crucial in such cases. Conclusion: effective management of SVT during pregnancy involves tailored anaesthetic techniques and vigilant monitoring to ensure optimal maternal and fetal outcomes while addressing the arrhythmia and its associated hemodynamic challenges.

References

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Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

Information not provided.

Conflicts of Interest

The authors report no conflicts of interest in this work.

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Cite this article

Bharath CJ, Suresh Kumar N, Gagan M. Anaesthetic management of pregnant patient with supraventricular tachycardia posted for emergency caesarean section. Ind J Anesth Analg. 2024;11(4):226-9.

Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Received Accepted Published
September 16, 2024 October 16, 2024 December 20, 2024
DOI: 10.21088/ijaa.2349.8471.11424.10

Keywords

Supraventricular Tachycardia (SVT)Pregnant womenSubarachnoid blockAdenosineAmiodarone

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Timeline

Received September 16, 2024
Accepted October 16, 2024
Published December 20, 2024

licence

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.



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