‘Of course. Is she booked with us?’
‘No.’ Emma shook her head. ‘They’re staying with family but I think she is carrying her notes. The husband told me that she’s thirty-three weeks. First baby.’
Sally hurried to the examination room and introduced herself to the couple. ‘How long have you been this breathless, Mrs Singh?’
‘For about a month.’ The woman was overcome by a severe bout of coughing and Sally frowned.
‘And you’ve seen your doctor?’
The husband nodded. ‘He said that she has a chest infection and he’s given her two different types of antibiotics. She was feeling a little better yesterday so we came up to stay with my brother, but suddenly in the night she was much worse.’
‘And you’ve had pains in your chest?’ Sally checked the woman’s temperature, pulse and blood pressure and offered her a drink as she started to cough again. ‘Mrs Singh, can you describe the pain in your chest?’
The woman gave an agonized gasp. ‘It happens when I breathe in. Such a sharp pain. The GP said it was infection.’
Sally nodded and quickly scanned the notes. ‘And when you cough, are you bringing anything up?’
Her husband nodded. ‘All night she coughed up clear, frothy stuff.’
Sally tucked some pillows behind the woman and gave her a smile. ‘Try not to worry. I’m going to find the consultant now and ask him to come and take a look at you. Then we’ll get you sorted out.’
She hurried onto the labour ward in search of Tom and saw him emerge from Theatre, a mask dangling round his neck.
‘Are you looking for me?’
He looked tough, male and far too tempting for her peace of mind.
Her heart kicked against her chest but she ignored the reaction and concentrated on the problem in hand.
‘There’s a woman in the examination room complaining of chest pain and difficulty breathing,’ she told him quickly. ‘Her GP has treated her with two lots of antibiotics.’
Tom lifted an eyebrow. ‘But?’
‘I don’t think she has a chest infection,’ Sally said immediately. ‘I think her symptoms might be cardiac.’
The moment she’d said the words she wished she hadn’t. She wasn’t a doctor and the woman’s GP had diagnosed a chest infection. What reason did she have to doubt him?
She waited stiffly for Tom to dismiss her assessment of the patient but he didn’t. Instead, his gaze fixed on hers intently.
‘Why do you think it’s cardiac?’
‘Because she’s coughing up clear, frothy sputum, she has tachycardia and she’s describing pleuritic chest pain,’ Sally said immediately. ‘I think she’s showing signs of pulmonary oedema. I’ve seen it before. I’m wondering whether she has rheumatic heart disease.’
‘You’ve seen it before?’ Tom frowned. ‘Mitral stenosis in British women is pretty rare.’
‘She was born in Pakistan and I saw several similar cases when I was working in a clinic there. It seems to be more common in Asian women. I have a bad feeling about her.’
Tom didn’t hesitate. ‘So let’s go and see her together and if necessary we’ll get the cardiologists involved. Did anyone listen to her heart when she booked?’
‘Yes, but there’s nothing in the notes.’
‘I’ll just grab a stethoscope and I’ll meet you in the room.’
Mrs Singh was coughing again when Tom walked into the room and Sally felt her heart skip a beat.
What if she was wrong?
What if it was just a simple chest infection that hadn’t cleared with the antibiotics?