Left atrial thrombosis in pregnant women with mitral stenosis and sinus rhythm.
OBJECTIVE
The purpose of this study was to describe pregnant patients with mitral stenosis who had intracardiac thrombosis in the absence of atrial fibrillation.


METHODS
We reviewed the clinical course of 3 pregnant women with severe mitral stenosis and normal sinus rhythm who had clinically significant intracardiac thrombosis.


RESULTS
The first patient was examined at 21 weeks of gestation with embolic stroke that was the result of left atrial thrombus. A second patient was found to have a large left atrial thrombus that prevented the performance of balloon valvuloplasty. The third patient had left atrial clot that partially occluded the mitral valve orifice and led to the development of pulmonary edema that resulted in an emergent cesarean delivery and anoxic brain injury in the newborn infant.


CONCLUSIONS
Pregnant patients with mitral stenosis in normal sinus rhythm can experience thromboembolic events that can be detrimental to both the mother and the fetus. Anticoagulation therefore should be strongly considered in this group.
Hameed
Afshan
A
Department of Obstetrics and Gynecology, University of California, Irvine, CA, USA.
Akhter
Mohammed W
MW
Bitar
Fahed
F
Khan
Salman A
SA
Sarma
Radha
R
Goodwin
Thomas M
TM
Elkayam
Uri
U
D000328:Adult; D005260:Female; D006325:Heart Atria; D006329:Heart Conduction System / Q000503:physiopathology; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology; D007231:Infant, Newborn; D008297:Male; D008946:Mitral Valve Stenosis / Q000150:complications* / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011256:Pregnancy Outcome; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016216:Ultrasonography, Prenatal