Anesthesia for cesarean section in patients with severe mitral stenosis with congestive heart failure

Providing anesthesia for cesarean section to a patient with mitral stenosis [MS] with congestive heart failure can be a big challenge. The authors present a report of a known patient of hypothyroidism, who presented with cardiac failure in 9[th] month of gestation with severe MS, significant resting pulmonary hypertension and pericardial effusion. She was successfully managed with epidural anesthesia and intrathecal fentanyl. A skillful multidisciplinary approach in the diagnosis and management can reduce the morbidity and mortality in patients of this setting