You are asked to review a 22-year-old woman who is known to have mitral stenosis. She is
currently at 12 weeks of gestation in her first pregnancy. She has had percutaneous mitral
commisurotomy in the past. Currently she is asymptomatic and is not on any medications. There is
no other medical or surgical history of note.
On examination:
• BMI = 22
• Pulse = 60 beats/minute and regular
• BP = 110/50 mm Hg
• Chest = clear; loud heart sounds with diastolic murmur over mitral area.
A recent echocardiogram showed moderate mitral stenosis with a large left atrium.
2) What plan would you put in place to optimally manage her pregnancy?