A 27-year-old Hispanic female, in second trimester of her pregnancy, presented to our emergency department (ER) with gradually worsening shortness of breath. The physical exam was significant for a loud S1, mid-diastolic murmur of mitral stenosis and basilar crackles. A chest X-ray was performed that showed bilateral pulmonary edema and straightening of the left heart border (Figure 1). The echocar-diogram further revealed left atrial enlargement and the classic 'hockey-stick' appearance of the anterior leaflet of mitral valve, consistent with rheumatic mitral stenosis (Figure 2). The patient was admitted to the cardiac intensive care unit and was treated with diuretics. The pregnancy, however, was deemed non-viable and had to be terminated.
展开▼
