Hi, I have a 36 y.o.G4P3 (3 miscarriages) and in her 35 week gestation came to OPD complaining of minimal coughing with shortness of breaths on excertions. She claims having dysuria . She is also having fever and chills. No hemoptysis . Appetite is tolerable. She was diagnosed several years back for RHD... with some degrees of MA, MS and AR. She has been having SOB for 7 days now... was seen 2 days ago at ER and sent home. On exam. she is quite letharic with some respiratory distress. Thin looking and pale. ENT: conjunctiva: pallor bilat. Lungs; rales bilat. CVS; grad. III syst. murmur(ms,mi) and grad. III dia. murmur (AR). ?pulsing JVP Ext: mild pedal edema bilat Abd: globular,,, can t auscult fetal heart tone... rest noncontributory... Assessment: mild CHF secondary VHD-RHD IUP R/O UTI Plan: Refer to ER... CBC/CHEM. AND UA No meds yet ordered... what would you suggested?