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.