Progressive Dyspnea in Medicine / Internal Medicine — 30yo Woman | Cardiology | SMLE Q#8192
SMLE Question #8192
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 30-year-old woman presents 3 days after an uncomplicated vaginal delivery with progressive dyspnea, paroxysmal nocturnal dyspnea, orthopnea, and cough. She also reports bilateral leg swelling for 1 week. She is in respiratory distress with bibasilar crackles and bilateral pitting edema. Cardiac exam shows a laterally displaced diffuse apical impulse, an S3 gallop, and a holosystolic murmur at the apex radiating to the axilla. What is the most appropriate next step in this patient’s management?
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