[Skip to Content]
[Skip to Content Landing]
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

McKusick VA:  Heritable Disorders of Connective Tissue . St Louis, CV Mosby Co, 1972.
Murdoch JL, Walker BA, Halpern BL, et al:  Life expectancy and causes of death in the Marfan syndrome.  N Engl J Med 1972;286:804-808.Crossref
Brown OR, DeMots H, Kloster FE, et al:  Aortic root dilatation and mitral valve prolapse in Marfan's syndrome.  Circulation 1975;52:651-657.Crossref
Spangler RD, Nora JJ, Lortscher RH, et al:  Echocardiography in Marfan's syndrome.  Chest 1976;69:72-78.Crossref
Hirst AE Jr, Gore I:  Marfan's syndrome: A review.  Prog Cardiovasc Dis 1973;16:187-198.Crossref
Come PC, Bulkley BH, McKusick VA, et al:  Echocardiographic recognition of silent aortic root dilatation in Marfan's syndrome.  Chest 1977;72:789-792.Crossref
Johnson ML:  Echocardiography , in Hurst JW (ed):  The Heart , ed 4. New York, McGraw-Hill Book Co, 1978, chap 32C.
Feigenbaum H:  Echocardiography . Philadelphia, Lea & Febiger, 1981.
Pyeritz RE, McKusick VA:  The Marfan syndrome: Diagnosis and management.  N Engl J Med 1979;300:772-777.Crossref
McDonald GR, Schaff HV, Pyeritz RE, et al:  Surgical management of patients with the Marfan syndrome and dilatation of the ascending aorta.  J Thorac Cardiovasc Surg 1981;81:180-186.
Pyeritz RE:  Maternal and fetal complications of pregnancy in the Marfan syndrome.  Am J Med 1981;71:784-790.Crossref
Mandel W, Evans EW, Walford RL:  Dissecting aortic aneurysm during pregnancy.  N Engl J Med 1954;251:1059-1061.Crossref