Anesthetic management in a patient with mitral stenosis associated with pregnancy induced hypertension

Patients with mitral stenosis associated with Pregnancy Induced Hypertension (PIH) continue to posea challenge to anesthesiologist and could be associated with an unfavorable maternal as well as fetaloutcome. Women with mitral stenosis often do not tolerate the cardiovascular demands of pregnancy.This increased volume load and tachycardia together cause the patients to deteriorate and advance fromone New York Heart association (NYHA) class to another. We report a, 28 year female, who underwentcesarean section under combined spinal-epidural anesthesia (CSEA). The uneventful course of theanesthesia in the presented case was due to the thorough systemic evaluation and careful anestheticstrategy.