A 27-year-old previously healthy woman with no prior history of exercise limitations, shortness of breath, cyanosis, or arrhythmia became short of breath 10 months after her second successful pregnancy. Her shortness of breath was at rest accompanied by progressive edema, ascites, and later anasarca. An ECG revealed normal sinus rhythm with right atrial enlargement ( Figure 1A) , and chest x-ray revealed normal lung parenchyma with mildly enlarged cardiac silhouette ( Figure 1B) . A

more »

... c echocardiogram demonstrated reduced left ventric-