Cardiorespiratory symptoms during pregnancy - not always pulmonary embolism

We describe a case of sudden onset severe cardiorespiratory compromise in a parturient at 36 weeks' gestation. She received treatment for infection, pulmonary oedema and pulmonary embolism before a diagnosis of aortic dissection was made. Successful repair was undertaken following caesarean section. We discuss the difficulties of diagnosis of cardiorespiratory symptoms and the potential hazards of instituting therapy before a definitive diagnosis is reached. The value of a multidisciplinary team approach and the use of portable echocardiography in the investigation of both pulmonary embolism and cardiac disease are emphasised.