A 25 Year old Pregnant woman presents with Palpitations...

This ECG was recorded from a 25-year-old pregnant woman who complained of an irregular heart beat. Auscultation revealed a soft systolic murmur but her heart was otherwise normal.

What does the ECG show and what would you do?

The ECG shows:
• Sinus rhythm
• Ventricular extrasystoles
• Normal axis
• Normal QRS complexes and T waves


Clinical interpretation
The extrasystoles are fairly frequent but the ECG is otherwise normal. Ventricular extrasystoles are
very common in pregnancy, and systolic murmurs are almost universal. Her heart is almost certainly
normal.

What to do
Remember that anemia is a common cause of a systolic murmur. Doubts about the significance of
the murmur can be resolved by echocardiography, but this need not be performed in every pregnant  woman - it is best reserved for the investigation of apparently important murmurs that persist after
delivery.
The patient should be reassured and the extrasystoles left untreated.

Diagnosis: Sinus rhythm with ventricular extrasystoles.