The Internist and Mitral Stenosis in Pregnancy

The internist and obstetrician have usually managed the pregnant patient in heart failure as a result of mitral stenosis solely by medical measures. This has been based on the experiences and on the literature of the past and has not given proper consideration to the surgical correction of mitral stenosis. This case report exemplifies the problem the internist may encounter relative to the use and proper timing of mitral-valve surgery in the pregnant cardiac. Furthermore, it emphasizes that the surgical correction of mitral stenosis can be lifesaving, even in a moribund patient. Report of Case A 25 year old white female was first seen at Wesley Hospital in April of 1961 (Fig 1). Three days earlier she had experienced disabling shortness of breath, orthopnea, and dependent edema. The patient was five months pregnant and had had no prior difficulty. On the basis of four episodes of arthralgia between the ages