title: An ethical dilemma: severe ischaemic mitral regurgitation and acute coronary syndrome in a 49-year-old pregnant woman.
abstract: We report the case of a 49-year-old woman who presented with symptomatic severe mitral regurgitation secondary to previous myocardial infarction. During the work-up for surgery, she was found to be pregnant. This report explores the difficulties and ethical dilemmas encountered dealing with the need for urgent valve surgery and coronary revascularization in association with an unplanned, but wanted pregnancy in an older woman.
authors.affiliation: Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, Du Cane Road, London, UK. anna.john@doctors.org.uk
authors.forename: Anna S
authors.initials: AS
authors.lastname: Herrey
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Germain
authors.forename: Catherine
authors.initials: C
authors.lastname: Nelson-Piercy
authors.forename: Raffi R
authors.initials: RR
authors.lastname: Kaprielian
authors.forename: Phillip
authors.initials: P
authors.lastname: Bennett
authors.forename: Prakash P
authors.initials: PP
authors.lastname: Punjabi
authors.forename: Petros
authors.initials: P
authors.lastname: Nihoyannopoulos
mesh_terms: D000032:Abortion, Therapeutic; D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D004452:Echocardiography; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000628:therapy; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications
chemical_list: D010975:Platelet Aggregation Inhibitors