Amara is a 35-year-old G2P2 with African ancestry who presents three weeks postpartum with shortness of breath, orthopnoea, tachypnoea and cough productive of pink frothy sputum. 

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<p>Amara is a 35-year-old G2P2 with African ancestry who presents three weeks postpartum with shortness of breath, orthopnoea, tachypnoea and cough productive of pink frothy sputum.</p><p>She was induced at 38 weeks’ gestation for pre-eclampsia and delivered her twin girls vaginally, without complication. Her blood pressure was well controlled on oral labetalol and amlodipine when discharged from hospital.</p><p>On examination, Amara’s blood pressure is 152/106mmHg, pulse is 120bpm and oxygen saturation is 85% on room air. Jugular venous pressure is 6cm.</p><p>On auscultation, there are fine bibasal crackles and normal heart sounds. She is referred to ED, where a chest CT is performed (pictured).</p>

References on request from Dr Kate Kelso.