Cesarean section in a patient with dilated cardiomyopathy and cardiac resynchronization therapy-defibrillator: a case report

Abstract Background: Cardiac disease in pregnancy, especially with reduced ejection fraction and implanted devices like CRTDs is uncommon, it poses significant maternal and fetal risks. Anaesthetic management must be carefully planned to ensure hemodynamic stability. Case: Presentation: A 42-year-old G2P1 woman at 32 weeks gestation presented with decreased fetal movements. She was diagnosed with intrauterine growth restriction and scheduled for elective cesarean section. Her history included dilated cardiomyopathy (EF 30%), CRTD, and gestational diabetes. A combined spinal-epidural anesthesia was used. Multidisciplinary coordination ensured a stable perioperative course and favorable neonatal outcome. Conclusion: pleaseWith thorough planning and team-based care, regional anesthesia can be safely employed in high-risk cardiac pregnancies, even in patients with advanced cardiac devices.