Physiological Changes in Pregnancy
You are called in to evaluate the heart of a 19-year old primigravida at term. Listening carefully to the heart, you determine that there is a normal S2, S3 easily audible with a 2/6 systolic ejection murmur greater during inspiration, you immediately recognize that (DNB Dec 2011)
|A||The presence of S3 is abnormal|
|B||The systolic ejection murmur is unusual in a pregnant woman at term|
|C||Wide pulse pressure is rare in pregnant women|
|D||All findings recorded are normal changes in pregnancy|
All findings recorded are normal changes in pregnancy
a. Numerous changes occur in the cardiovascular system during pregnancy.
b. Heart rate increases by about 10 to 15/mm. Blood volume and cardiac output increase significantly Many cardiac sounds that would be abnormal in a nonpregnant state are normal during pregnancy.
c. All the findings listed in the question are normal. Ninety percent of pregnant women have systolic ejection murmurs. In approximately 20% of women, a soft diastolic murmur can be heard.