Dear friend, welcome to HCM !
She seems to be a case of operated VSD closure 12 years ago, now pregnant with anaemia
A pan systolic mitral murmur may be due to anaemia (Haemic murmur) or a VSD murmur.
2D echo will give right insights.
Her ECG shows RBBB with atrial ectopics.
She will need electrolytes, routine basic biochemistry, 2D echo doppler and a cardiology consultation and a gynaecology consultant experienced in high risk pregnancy.
Take care and please keep me informed of your progress.
Good Luck !
I hope to have answered your query satisfactorily.
May I request for your rating and review of this answer before you accept the answer and close the query (if there are no more follow up questions)?
Thank you !