A 32-Year-Old Primigravida at 28 Weeks Gestation Is Referred from the Obstetrics

A 32-year-old primigravida at 28 weeks gestation is referred from the obstetrics clinic due to shortness of breath.  She is an immigrant from Mexico.  Her pregnancy has thus far been uncomplicated except for nausea in the first trimester.  Over the last four weeks, she has been feeling tired and becomes short of breath with activities that she was previously able to perform with ease, such as walking several blocks or climbing stairs on the subway.  She denies chest pain, wheezing, cough, or nocturnal symptoms.  Her other medical problems include obesity and mild intermittent asthma.  Cardiac auscultation findings can be heard in the exhibit.
Which of the following is the most likely diagnosis?

A) Aortic stenosis
B) Mitral stenosis
C) Normal pregnancy
D) Peripartum cardiomyopathy
E) Ventricular septal defect

Correct Answer:

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