TY - CHAP M1 - Book, Section TI - Thorax A1 - Hankin, Mark H. A1 - Morse, Dennis E. A1 - Bennett-Clarke, Carol A. PY - 2017 T2 - Clinical Anatomy: A Case Study Approach AB - Patient PresentationDuring a scheduled prenatal visit, a 34-year-old in the 24th week of her first pregnancy complains of shortness of breath and fatigue. During a couple of recent exercise sessions she noticed that her heart was "racing." During one of these episodes, she noticed a small amount of blood in her saliva.Relevant Clinical FindingsHistoryThis patient emigrated from India to the United States 10 years ago. She indicates that there is no family history of cardiovascular or respiratory disease. She does not have records for childhood immunizations and illnesses. To date, her pregnancy has been unremarkable.Physical ExaminationNoteworthy vital signs:Pulse: 122 bpm Adult resting rate: 60–100 bpmFetal pulse: 143 bpm Baseline fetal rate: 110–160 bpmResults of physical examination:Auscultation over the heart apex with the patient in left decubitus position reveals a mid-diastolic murmur and a systolic "snap."Crackles are detected in all lung lobes.Imaging StudiesEchocardiography reveals calcification in both leaflets of the mitral valve, doming of the anterior leaflet, and thickened and shortened chordae tendineae. The left atrium is enlarged.ElectrocardiogramAtrial fibrillationClinical Problems to ConsiderAtrial myxomaMitral valve prolapseMitral valve stenosis SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accessphysiotherapy.mhmedical.com/content.aspx?aid=1145870829 ER -