Summary:
In this otherwise healthy young woman with no associated cardiovascular abnormality, this was considered to be "a physiologic S3." No further studies were deemed necessary.
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to review auscultation.
Lessons:
- With pregnancy the circulation is hyperkinetic and increased plasma volume leads to a lowered hematocrit which reduces the viscosity of the blood.
- These factors promote the occurrence of innocent systolic murmurs and physiologic third heart sounds.
- PEARL: This S3 would be inaudible with the diaphragm
end-piece.
Case 3 is now finished.