Cardiovascular System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This lady has presented with worsening dyspnea in late pregnancy.\n\nGiven her background of valvular heart disease, it is tempting to conclude that this must be the underlying etiology.\n\nHowever, it is important to appreciate that several other diseases can present in this manner - particularly anemia, peripartum cardiomyopathy, pneumonia, and pleural effusions.\n\nOne should also note that the physiological changes of pregnancy (particularly fluid retention) can also give rise to dyspnea; this effect can be pronounced in patients with aortic stenosis (AS), due to the high transvalvular pressure gradient.\n\nShe is not clinically anemic, while her full blood count shows a normal hemoglobin level; in addition, her examination is negative for sign"}]}

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