Pregnany with Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)

CPVT is a rare inherited condition characterised by life

threatening cardiac arrythmias. The lethality rate of the condition is around

30-50%.

Case report: A 31 years old lady had two Caesarean sections at term

with no complications from CPVT. She was on B- Blockers from the age of

9. She was followed up in our department in both her pregnancies. She

underwent both LSCS at term after uneventful pregnancies. Her follow ups

included serial growth scans, foetal ECHO and liasing with other

specialities such as cardiology, electrophysiology, maternal foetal medicine,

anaesthesia, neonatology to reduce foeto-maternal complications from the

disease.

Discussion: Literature search shows that the pregnancy and postpartum

cardiac events in women include syncope, cardiac arrest particularly in

those not taking B- Blockers. Foetal complications included miscarriages

and intra-uterine growth restriction. In our case, there was intra-uterine

growth restriction in her second pregnancy, with no other foeto- maternal

complications.

Conclusion:

Despite being a rare and dangerous condition, CPVT is not a contra-indication

to pregnancy. Most anti-arrythmic drugs prescribed are life – saving and have

low risk of teratogenesis. However, potential for CPVT destabalisation occurs if

anti-arrythmic drugs are decreased or stopped, when ICD shock exacerbates

catecholamine response or during adrenaline surges by labour or delivery.

Authors: Dr Chhavi 1 , Speciality Doctor, OBG

Mr Ajith Wijesiswardana 2, Consulant OBG

Cumberland Infirmary, NCIC NHSFT, Carlisle, UK