The presentation of acute dyspnea after pregnancy is rare, but should bring a number of important conditions to the mind of the attending physician. Pulmonary embolism, amniotic fluid embolism, pneumonia, aspiration and pulmonary edema are some of the potentially devastating causes that must be considered. The percentage of pregnancies that are complicated by acute pulmonary edema has been estimated to be 0.08%. The most common contributing factors include the administration of tocolytic agents, underlying cardiac disease, iatrogenic fluid overload and preeclampsia. No matter what the underlying pathology, prompt administration of appropriate resuscitation is always the first priority. Only after the patient has been stabilized can attention be turned to diagnosis and specific treatment. This case examines one such presentation and reviews some of the diagnostic possibilities.
