ABSTRACT
This is a report of pulmonary edema following cesarean section under spinal anesthesia in a patient with valvular heart disease. The patient was a 38-yr old multigravida woman without history of cardiac disease. She was operated under spinal anesthesia and remained haemodynamically stable throughout the procedure. But she developed respiratory distress at the end of operation in the recovery room. The only finding in ECG of the patients was sinus tachycardia and chest X-ray revealed bilateral pulmonary edema. The result of echocardiography was suggestive of moderate to severe mitral stenosis. Diagnosis of pulmonary emboli was excluded by perfusion scan. The patient was treated with diagnosis of pulmonary edema and after two hours the patient showed some improvement. Result of the echocardiography on the next day, confirmed the diagnosis. Physical examination should be performed carefully in order to determine the proper method of anesthesia. Spinal anesthesia in patients with mitral stenosis, in particular in pregnancy may not be well tolerated and should be performed cautiously