ECG Case #21 - Question #1

A 35 year old female with no significant past medical history is 30 weeks pregnant. She presents to the ED with severe shortness of breath. Her blood pressure is 90/50, heart rate 120, respiratory rate 24, and oxygen saturation 88% on room air. Heart examination reveals a diastolic opening snap and an early diastolic decrescendo murmur at the apex as well as a short late diastolic crescendo murmur.

What are the ECG findings on this rhythm strip?