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Congenital heart disease in pregnancy is rare but poses anesthetic challenges. Occasionally, pregnant women with pulmonary hypertension and atrial septal defects (ASD) present for anesthesia. These individuals have a higher likelihood of developing perioperative cardiovascular problems, making them high-risk candidates for anesthesia. Anaesthesia necessitates constant pulmonary and systemic hemodynamic stability as well as extensive cardiovascular monitoring. Physiological changes in pregnancy are poorly tolerated in presence of PAH. This is a case of a primigravida with a large Atrial septal defect and moderate pulmonary hypertension with moderate tricuspid regurgitation undergoing a successful elective cesarean section with epidural anesthesia.
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