Document Type : Case report


1 Mashhad University of Medical Sciences, Mashhad, Iran

2 Student Research Committee, Birjand University of Medical Sciences, Birjand, Iran

3 Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran


Coronavirus disease 2019 (COVID-19) is a rapidly growing health concern claiming over 6 million lives as of April 2022. Some evidence revealed that pregnancy increases the risk of severe illness with Coronavirus infection. COVID-19 also complicates the pregnancy results such as the number of cesarean deliveries and premature births. Mitral stenosis is a structural heart disease that endangers the patient and their newborn, accompanied by serious morbidity and mortality. The present patient, 40 years old gravida 2 para 1 at 37 weeks presented to the emergency department with progressive dyspnea following fever and malaise for a week. SARS-CoV-2 testing was positive ergo appropriate treatment was administered. CT scan showed severe COVID-19 pneumonia with a severity index of 23. Due to respiratory distress, the patient was readily admitted to the intensive care unit. The patient was supported with non-invasive ventilation. Nevertheless, NIV was insufficient with signs of respiratory fatigue so the patient was intubated. Despite the subsidence of fever and stable clinical condition patient remained tachycardic which promoted us to perform echocardiography revealing severe mitral stenosis. This report contains our experience and suggestions regarding this rare concurrence. The paucity of data is significant regarding the management of concurrent structural heart disease and COVID-19 in pregnancy. It should be emphasized that the importance of maintaining routine care and screening during the pandemic; which can be catastrophic if missed.