Which cardiovascular change is physiological in last trimester of pregnancy:: (A) Middiastolic murmur, (B) Occasional atrial fibrillation, (C) Shift of apical impulse laterally and upwards in left 4th intercostal space, (D) Cardiomegaly
Answer is C. There is diaphragmatic elevation in pregnancy with the growing uterine size which pushes the hea upwards and outwards thus leading to Shift of apical impulse laterally and upwards in left 4th intercostal space. This change is more Prominent in last trimester of pregnancy Mid diastolic murmur, atrial fibrillation and cardiomegaly are all abnormal findings in pregnancy that require fuher evaluation