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April 1983

Acute Pulmonary Edema in a Pregnant Patient

Author Affiliations

From the Division of Cardiology (Drs Baltazar and Mower) and the Departments of Medicine (Drs Aquino and Friedman) and Radiology (Dr Udoff), Sinai Hospital, Baltimore.

Arch Intern Med. 1983;143(4):781-783. doi:10.1001/archinte.1983.00350040171024

A 31-year-old woman was in generally good health, except for a heart murmur present since the age of 2 years. In the 14th week of her first pregnancy, she had had nausea and vomiting followed shortly thereafter with dizziness and a notable shortness of breath. Family history showed that a nephew was tall and lanky. Physical examination disclosed a pale dyspneic and diaphoretic patient who had a BP of 96/50 mm Hg and a heart rate of 120 beats per minute. Her height was 185 cm, arm span was 190 cm, and she had a high-arched palate. The fingers and toes were long, tapering, and spindly, with hyperextension and laxity of the joints. The neck veins were engorged. A systolic thrill was palpable over the suprasternal area radiating to both carotid arteries. A grade 2/6 crescendo-decrescendo midsystolic murmur was heard at the apex and along the left sternal border, and

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