Case presentation
On 5 November 2021, a 35-year-old G3P02L02 with a gestational age of 34+5 weeks was admitted to our hospital with a shortness of breath function class 2, myalgia, complaining of headache, tachycardia, fatigue and productive coughs that caused chest pain while started 1 week ago and intensified 2 days ago. The patient had several visits to the general practitioner and received serum therapy before admission, but did not recover. Her past medical history reported tachycardia in her past pregnancy and left lobe thyroid nodule that are compatible with papillary thyroid carcinoma through fine needle aspiration which was diagnosed at eighth week of pregnancy and according to the absence of lymphadenopathy and extrathyroidal invasion,postpartum surgery was recommended.
She had a history of tachycardia in previous pregnancy and had also been treated with Inderal for the last 5 years before discontinuing it for pregnancy. During this pregnancy, she did not have any referrals for heart problems. The patient was also being treated with levothyroxine due to hypothyroidism. Continuing the history of previous diseases, she also had a mild gestational diabetic mellitus (GDM) since 5th month of pregnancy and had been under treatment with 6-unit bedtime detemir. The patient had a platelet count of 70,000 at the admission, but no schistocytes were seen in the peripheral blood smear.