13^th European Cardiology Conference

Biography

Biography: Abdullah Nabi Aslan

Abstract

A 34-year-old woman with GS presented at 20 weeks gestation with the complaints of palpitation, fatigue and presyncope. This was her first pregnancy. Her initial diagnosis of GS had been confirmed 4 years ago based on clinical presentation and laboratory data. She was maintained on oral electrolyte replacement with oral potassium chloride and magnesium citrate were prescribed and the course of the pregnancy. At physical examination there was a grade 3/6 systolic ejection murmur maximally heard at apical focus of the heart. Blood pressure was 80/50 mmHg and laboratory test showed a serum potassium value of 2.5 mmol/L (normal 3.5-5.1), a serum calcium value of 10.2 mg/dL (normal 8.6-10.0) and a serum magnesium level of 1.4 mg/dL (1.6-2.6) were noted. Blood gas analysis showed metabolic alcalosis with a pH  of 7.495 (normal 7.380-7.460), pCO2  of 35.6 (normal 32-46) and HCO3 of 34.1 mmol/L (normal 22-26). Serum creatinine, urea and remainder ionograms were normal. Electrocardiogram (ECG) showed normal sinus rhythm with a rate of 67 beats per minutes and remarkable ST-T changes at inferior and precordial derivations. There was also a prolonged QT interval (490 ms) (Fig 1).  Echocardiography determined a hypertrophic obstructive cardiomyopathy (HOCM) with a septal thickness of 2.1 cm and posterior wall thickness of 1.1 cm (Fig.2a) and a resting gradient of 30 mmHg (Fig. 2b). There was also systolic anterior motion in mitral valve creating a mild degree of mitral regurgitation (video). Risk of SCD at 5 years was calculated as 2.93%. Because the patient was pregnant, the cardiology, gynecology and pediatric departments organised a council whether the patient will maintain the pregnancy or not. The common consensus  was close follow-up and if needed termination. At follow-ups, the pregnancy was continued without any complication with a born healhy daughter.