25th May 2025

A 32-year-old primigravida presents with dyspnoea on exertion during her second trimester.

A 32-year-old primigravida presents with dyspnoea on exertion during her second trimester. Her parents immigrated to the UK from Uganda before she was born. She is needing to prop herself with 2 pillows at night to sleep comfortably. Previous physical examinations had disclosed no cardiac abnormalities. On current physical examination, she has a loud first heart sound and a 2/6 diastolic rumble. What is the most likely cause of her symptoms?

Select the SINGLE most appropriate option from the list below. Select ONE option only.