Lutembacher’s Syndrome Presenting in the Third Trimester: A Multidisciplinary Challenge in a Low-Resource Setting

Background Lutembacher’s Syndrome is a rare case, defined as Mitral valve stenosis in association with atrial septal defect (ASD). Both defects, Mitral stenosis and ASD may be congenital or acquired in origin. Poses significant challenges during pregnancy. The prevalence of this syndrome is not well-documented, but it is considered rare. Case presentation: We report the case of a 40-year-old Afghan pregnant woman presenting with NYHA class IV heart failure symptoms one day before labour. Echocardiography revealed severe mitral stenosis, a large secundum ASD with left-to-right shunt, severe pulmonary hypertension, and multivalvular regurgitation. She also had atrial fibrillation, anemia, and fetal congenital heart defects. Medical stabilization allowed successful assisted vaginal delivery of a preterm infant. Despite the need for urgent postpartum surgery, intervention was refused due to financial and cultural constraints. Conclusion This first reported case of Lutembacher’s syndrome in Afghanistan underscores the critical impact of late diagnosis, particularly in pregnant women, where the physiological burden of pregnancy can exacerbate undetected cardiac disease. In resource-limited settings, economic problems and cultural barriers often delay both diagnosis and timely intervention. Such delays increase the risk of severe maternal and fetal complications, making pregnancy management significantly more complex.