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35 weeks gestation, minimal cough with shortness of breath, fever, SOB. Assessed with mild CHF, secondary VHD-RHD. Treatment?

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?
Asked On : Sat, 29 Dec 2012
Answers:  1 Views:  40
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OBGYN 's  Response
Thanks for writing to us.
The examination findings that you have described are suggestive of a congestive heart failure due to a cardiac problem. She needs a careful treatment under the care of a cardiologist and a gynecologist to save her baby.
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Dr. Rakhi Tayal
Answered: Mon, 14 Jan 2013
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