Severe Aortic Valve Stenosis During Pregnancy: Role of Multidisciplinary Pregnancy Heart Team to Guide Decision-Making.

Document Type

Article

Publication Date

8-13-2025

Publication Title

JACC. Case reports

Abstract

BACKGROUND: Pregnant women with underlying cardiovascular disease are at an increased risk of maternal-fetal morbidity and mortality especially in the setting of symptomatic stenotic valvular heart disease.

CASE SUMMARY: A 35-year-old female at 17 weeks gestation presented to the emergency department with exertional dyspnea for 3 months and was diagnosed with decompensated heart failure. Echocardiogram demonstrated left ventricular ejection fraction of 45% with severe aortic valve stenosis and moderate aortic regurgitation. A multidisciplinary pregnancy heart team recommended urgent surgical aortic valve replacement prior to fetal maturity.

DISCUSSION: Hemodynamic changes in pregnancy, such as increased blood volume and heart rate, may unmask asymptomatic cardiovascular disease. Specifically, increased blood volume during pregnancy is poorly tolerated in patients with stenotic valvular disease and may result in NYHA functional class III or IV heart failure.

TAKE-HOME MESSAGE: Cardiovascular comorbidities in pregnant women require careful evaluation by a multidisciplinary pregnancy heart team to determine optimal timing and approach for intervention.

Volume

30

Issue

23

First Page

104453

DOI

10.1016/j.jaccas.2025.104453. PMID: 40816852.

ISSN

2666-0849

PubMed ID

40816852

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