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Peripartum cardiomyopathy — RCPSC IM MCQ

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HardCardiologyPeripartum cardiomyopathyRCPSC IM

A 33-year-old woman at 35 weeks gestation presents with orthopnea, bibasal crackles and new atrial fibrillation. Blood pressure is 148/94 mmHg. Echocardiography shows a dilated left ventricle with ejection fraction 28% and moderate functional mitral regurgitation. Urinalysis has no proteinuria and platelets are normal. What is the most likely diagnosis?

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Correct answer: C — Peripartum cardiomyopathy

Late pregnancy heart failure with reduced ejection fraction, no significant proteinuria and no alternative cause supports peripartum cardiomyopathy.

Reference: Royal College sample written examination; CCS heart failure guidance