May 13, 1968

Obstetrical Anesthesia in Myocardial Infarction and Complete Heart Block

Author Affiliations

From the Department of Anesthesiology (Drs. Giuffrida, Bizzarri, and Lagman), and the Department of Obstetrics and Gynecology (Dr. Grimaldi), New York Medical College-Metropolitan Hospital Center, New York.

JAMA. 1968;204(7):617-620. doi:10.1001/jama.1968.03140200057018

To our knowledge, no case of pregnancy complicated by complete heart block and old myocardial infarction has been reported. In this communication, we shall describe the obstetrical course and anesthetic management of a pregnant patient with these unusual complications.

Report of a Case  A 35-year-old woman was admitted to Metropolitan Hospital in December 1960 with an acute myocardial infarction of the anterior wall, complete heart block, and syphilitic aortitis. Before this admission, she had delivered four children uneventfully, the last child having been born in May 1960. After treatment of the acute episode, she was followed up by the Home Care Service as a class 3-C cardiac (as defined by the New York Heart Association). She received pentaerythritol tetranitrate, 10 mg four times a day, and her physical activities were restricted because of easy fatiguability and angina pectoris.At age 40, the patient again became pregnant. Her expected date of