title: A patient with rheumatic heart disease presented with central cyanosis due to acquired methemoglobinemia during late pregnancy - A rare association.
abstract: A 21-year-old pregnant female of known rheumatic heart disease presented to us for evaluation of central cyanosis during her late pregnancy. Though she was investigated for any associated congenital heart disease or pulmonary arteriovenous fistula, but incidentally she was diagnosed of having acquired methemoglobinemia. Her serum methemoglobin level was 33% which was far above the normal range. Ultimately, she was managed conservatively and delivered through elective caesarean section. Though the delivered baby was lethargic after birth, but later he was improved and discharged. This was the first case reported so far that a pregnant patient of rheumatic heart disease developed cyanosis due to methemoglobinemia.
authors.affiliation: Post Doctoral Trainee, Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bannerghatta Road, Bangalore, Karnataka 560069, India.
authors.forename: Soumya
authors.initials: S
authors.lastname: Patra
authors.forename: Jayashree
authors.initials: J
authors.lastname: Kharge
authors.forename: Ashalatha
authors.initials: A
authors.lastname: Bharatha
authors.forename: Ramegowda T
authors.initials: RT
authors.lastname: Raghu
authors.forename: Cholenahally N
authors.initials: CN
authors.lastname: Manjunath
keywords: Methemoglobinemia; Pregnancy; Rheumatic heart disease
references.citation: Thorax. 1986 Apr;41(4):333-4
references.pmid: 3738855
references.citation: Med Hypotheses. 2007;68(5):1114-9
references.pmid: 17112681
references.citation: Environ Health Perspect. 2006 Mar;114(3):320-7
references.pmid: 16507452
references.citation: South Med J. 2011 Nov;104(11):757-61
references.pmid: 22024786
references.citation: Jugosl Ginekol Opstet. 1978 May-Aug;18(3-4):321-4
references.pmid: 757250
references.citation: Acta Anaesthesiol Scand. 2005 Apr;49(4):586-8
references.pmid: 15777313
references.citation: J Toxicol Clin Toxicol. 1995;33(6):713-6
references.pmid: 8523499
references.citation: S Afr Med J. 1985 Jan 5;67(1):23-4
references.pmid: 3966180