Diagnosed corrected transposition of great arteries after cesarean section: A case report

Naoki Ichii1, Toshiyuki Kakinuma2, Atsushi Fujikawa3

  • 1Department of Obstetrics and Gynecology, International University of Health and Welfare Hospital, Tochigi 329-2763, Japan.

Insights

Corrected transposition of the great arteries (cTGA), a congenital heart defect, can lead to acute heart failure in postpartum patients. Early detection and management are crucial for improved outcomes in these complex cases.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Maternal-Fetal Medicine

Background:

  • Corrected transposition of the great arteries (cTGA) involves reversed ventricular and arterial positions, often leading to systemic circulation overload and heart failure.
  • This condition typically presents a poor prognosis, necessitating careful monitoring, especially in vulnerable populations.
  • Pregnancy can exacerbate underlying cardiac conditions, posing risks to both mother and fetus.

Observation:

  • A 36-year-old postpartum patient, 18 days after an elective cesarean section, presented with acute heart failure symptoms including dyspnea and bilateral pleural effusions.
  • Initial assessment revealed pedal edema and reduced oxygen saturation (SpO2 91%).
  • Computed tomography confirmed the presence of cTGA without other identified cardiac anomalies.

Findings:

  • The patient was diagnosed with acute heart failure secondary to undiagnosed cTGA.
  • Medical intervention led to significant improvement in edema and pleural effusions.
  • The patient was discharged on postoperative day 9.

Implications:

  • Highlights the importance of considering congenital cardiac malformations in postpartum patients presenting with heart failure symptoms.
  • Suggests the need for enhanced cardiac screening during perinatal care, particularly in cases with risk factors.
  • Emphasizes prompt diagnosis and management of cTGA in pregnancy to prevent severe maternal morbidity.
Abstract