You asked to evaluate a pregnant female in the obstetrics department who has been complaining of severe shortness of breath for the last 5 h. She was admitted one day earlier, in her 30th week of gestation for premature labour. She was started on intravenous terbutaline and had been doing well. About 6 h ago she started complaining of shortness of breath that has been progressively worsening. She denies any chest pain, palpitations or lower limb pain and swelling. She has no past medical history of note and her prenatal examination had been normal. Physical examination reveals a dyspnoeic lady with respiratory rate of 25/minute, blood pressure 115/90 mmHg, and pulse 122/minute. She has jugular venous distension and bilateral diffuse inspiratory crackles. White cell count 11 × 109/l Hemoglobin 12 g/dl Platelet 660 × 109/l Electrocardiogram (ECG) Sinus tachycardia Chest X-ray Bilateral alveolar type infiltrates and normal cardiothoracic ratio Which of the following is most likely diagnosis? Peripartum cardiomyopathy Pulmonary embolism Myocarditis Mitral stenosis Tocolysis-associated pulmonary oedema
Posted on: Sat, 24 Aug 2013 07:05:04 +0000
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