Anaesthetic management of a parturient with an incidental large fossa ovalis undergoing elective caesarean section

The fossa ovalis, a remnant of the foramen ovale, usually closes after birth. Timely identification and treatment of cardiac issues during pregnancy are essential to prevent harm to both the mother and the fetus. A 28-year-old primigravida, 36 weeks and 4 days pregnant, presented with symptoms of palpitations and dyspnea. Echocardiography revealed a 2.5 cm fossa ovalis with an atrial septal defect (ASD) and a left-to-right shunt. Epidural anesthesia was administered, and no significant intraoperative complications were observed.