Pregnancy Dyspnea & Tachycardia Clinical Decision Tree

Algorithm for evaluating a pregnant patient presenting with mild dyspnea and tachycardia

Pregnant Patient with Mild Dyspnea & Tachycardia

Initial evaluation

Start

Blood Pressure ≥ 140/90 mmHg?

Check for hypertension

Yes

Evaluate for Preeclampsia

Proteinuria Test

Liver Enzymes (AST/ALT)

Platelet Count

Serum Creatinine

Headache Assessment

Pulmonary Edema

Severe signs?

Severe Preeclampsia

Immediate obstetrical consultation required

Check Oxygen Saturation

Pulse oximetry reading

O₂ Sat < 95%?

Hypoxemia Evaluation

Arterial Blood Gas (ABG)

Pulmonary Embolism (PE)

History of DVT?

Obesity (BMI > 30)?

Recent immobility?

D-dimer (interpret cautiously)

High suspicion?

Pulmonary Embolism (PE)

CTPA or V/Q scan required

Cardiac Causes

Orthopnea?

Leg swelling?

ECG

BNP

Echocardiography

Findings?

Peripartum Cardiomyopathy

Cardiology consultation required

Thyrotoxicosis

Anxiety?

Weight loss?

Palpitations?

TSH, Free T4

Severe?

Thyroid Storm

Endocrine emergency

Oxygen Saturation ≥ 95%

Pneumonia

Cough?

Fever?

Rales on auscultation?

CBC, CRP, Chest X-ray

Findings?

Pneumonia

Antibiotics per guidelines

Anemia

Fatigue?

Pallor?

CBC: Hemoglobin, MCV

Findings?

Anemia

Iron studies, consider supplementation

Physiological Changes of Pregnancy

Mild symptoms, normal workup

Color Coding Legend

Critical (Immediate action required)

Warning (Needs evaluation)

Normal/Physiologic