Resuscitation, revival, and birth: a case report of cardiac arrest in a pregnant woman with repaired congenital heart disease

Surgical correction of congenital cardiac defects in infancy is being increasingly prevalent there is an increasing population of patients reaching adulthood with corrected congenital heart disease. Pregnancy in these patients can be particularly dangerous and risk stratification is key. Complications during pregnancy can still occur, which in the context of corrected congenital cardiac disease may require unique care.

A 30-year-old patient in her third trimester of pregnancy presented to hospital with acute onset chest pain and shortness of breath. She had a background of congenital corrected pulmonary atresia via a Modified Blalock-Thomas-Taussig shunt which required conduit replacements through her adolescence and a ventricular septal defect (VSD) repaired with a Dacron patch. Routine echocardiograms and electrocardiograms had been stable through her pregnancy. On this occasion, she rapidly deteriorated on presentation to the emergency department and suffered a 15-minute ventricular fibrillation (VF) arrest during which she underwent a peri-mortem C-section. During her cardiac arrest, she developed CPR induced consciousness which led to some distressing recall of her treatment. Overall, this was felt to be scar related ventricular fibrillation (VF) and she left hospital after a 3-week admission with an implantable cardiac defibrillator. She and her newly born baby suffered no ill effects of this cardiac arrest.

This case highlights the necessity for early recognition, rapid intervention, and multidisciplinary collaboration in managing life-threatening maternal cardiac emergencies.