Rupture of the sinus of Valsalva in pregnancy

A 20y old , woman in week 34 of her first pregnancy attended her local hospital because of chest pain and dyspnea , and in her echocardiography VSD was reported . But , because of begining her labor pain and uterin contraction her infant was born through vaginal delivery. In 3rd day after delivery she came to Rajaee Hospital because of increase in heart rate, and tachypnea. Subsequently a dry cough, dyspnea and orthopnea had developed. Examination showed tachycardia with 120 beats / min .Blood pressure was 120 / 60 and on auscultation a continuous mid systolic murmur was heard at the left sternal border.The CXR showed increased vascular marking and ECG was normal. In view of the possibility of pulmonary emboli, it was felt that CT.angiographic confirmation of the diagnosis should be obtained. There is no sign of PTE inCT. angiography. (fig 1)