The ECG shows:

• Sinus rhythm
• Ventricular extrasystoles
• Normal axis
• Normal QRS complexes and T waves

The extrasystoles are fairly frequent but the ECG is otherwise normal. Ventricular extrasystoles are very common in pregnancy, and systolic murmurs are almost universal. Her heart is almost certainly normal.

Remember that anaemia is a common cause of a systolic murmur. Doubts about the significance of the murmur can be resolved by echocardiography, Summary but this need not be performed in every pregnant Sinus rhythm with ventricular extrasystoles. woman – it is best reserved for the investigation of apparently important murmurs that persist after delivery. The patient should be reassured and the extrasystoles left untreated.