• B J Karas, Erin Ramirez, Carl Humbarger, and Adel Yaacoub.
• Franciscan Saint Elizabeth East Hospital, and Franciscan Lafayette Obstetrics and Gynecology, Lafayette, Indiana, USA.
• Obstet Gynecol. 2013 Aug 1;122(2 Pt 2):505-7.

BackgroundUndiagnosed maternal congenital heart disease can result in significant risks to both mother and fetus. When maternal symptoms and signs are atypical of preeclampsia, broadening the differential diagnosis and multidisciplinary consultation can lead to improved outcomes.CaseA 24-year-old primiparous woman with a pregnancy complicated by elevated blood pressure and proteinuria presented at term with symptoms of decreased fetal movement, increasing dyspnea, and cough. Her symptoms progressively worsened until she experienced cardiorespiratory arrest during attempted intubation. Emergency cesarean delivery was performed after 5 minutes of resuscitation efforts. Echocardiogram performed after delivery revealed cor triatriatum requiring surgical excision.ConclusionA complete differential diagnosis for edema, hypertension, and dyspnea near term will allow for recognition of more rare conditions. Referral to cardiology in cases in which work-up is negative for preeclampsia may aid in earlier diagnosis and management. A team approach to management involving obstetrics and medicine will improve the rapidity with which rare conditions can be managed effectively.

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