Question

A 38-year-old pregnant woman at 28 weeks with known rheumatic mitral stenosis (moderate severity) presents with increasing dyspnoea on exertion and orthopnoea. She is in sinus rhythm. What is the most appropriate initial management approach?

Accepted Answer

Start beta blocker and diuretics, and manage jointly with cardiology and high-risk obstetrics

Answer

Advise immediate termination of pregnancy

Answer

Start ACE inhibitor to reduce afterload

Answer

Start warfarin for stroke prevention

Answer

Perform elective caesarean section at 28 weeks immediately

Practice question

A 38-year-old pregnant woman at 28 weeks with known rheumatic mitral stenosis (moderate severity) presents with increasing dyspnoea on exertion and orthopnoea. She is in sinus rhythm. What is the most appropriate initial management approach?