INTRODUCTION: The presentation of acute dyspnea in postpartum is rare. Commonest causes like pulmonary embolism, amniotic fluid embolism, pneumonia, aspiration and pulmonary edema, must be considered. Around 0.08% of pregnancies are estimated to be complicated by acute pulmonary edema. The most common contributing factors for pulmonary edema include, administration of tocolytics, underlying cardiac disease, iatrogenic fluid overload and preeclampsia.

CASE REPORT: A 22yr old female patient with postpartum respiratory distress referred to our institution, 12 hrs after an emergency caesarean section in a private hospital.

CONCLUSION: Prompt administration and appropriate resuscitation is always the first priority. Only after the patient has been stabilized, attention can be turned to diagnosis and specific treatment. A diagnosis of severe Mitral Stenosis, probably of rheumatic origin was made after stabilizing the patient.