A- -years-old female comp...

A-25-years-old female complained shortness of breath for the past 3 days. She also experienced fatigue, dry cough, and orthopnea. She had given birth by caesarean section 5 months ago. She had no history of hypertension or coronary artery disesase before. Vital signs showed an increased of blood pressure of 140/90 mmHg, an increased of heart rate 115 beats per minute, an increased of respiratory rate of 28 breaths per minute, and a decreased of oxygen saturation levels of 93% at room air. On physical examination, wet rhonchi and wheeze were observed. Chest X ray examination showed pulmonary oedema, pleural effusion, and cardiomegaly. The laboratory finding was an elevated of white blood cells (18.900/cumm). The patient was diagnosed with acute heart failure suspected to peripartum cardiomyopathy and pleural effusion et causa, pneumonia. She was treated by oxygen supplementation via nasal canul 4 lpm, intravenous loop diuretic (furosemide 20 mg), and antibiotics.