Case 4: a 34-year-old African female, para 3+0, who delivered a healthy female newborn weighing 2,790g, presented to the emergency department 15 days post elective Cesarean section with difficulty in breathing (NYHA class IV), excessive productive cough with hemoptysis and bilateral lower limb swelling until the ankles. She reported having orthopnea, paroxysmal nocturnal dyspnea, and palpitations. Her past medical history was unremarkable. Upon presentation, the patient was in severe respiratory distress on 10L/minute of oxygen via a non-rebreather mask. She was afebrile with a blood pressure of 150/99 mm Hg, a pulse rate of 55 beats per minute, a respiratory rate of 21 breaths per minute, and an oxygen saturation of 85% on room air and 98% on oxygen. Physical examination showed bilateral lower limb pitting edema, jugular venous distention, and an S3 gallop. On respiratory exam, crepitations were heard on the right side with reduced air entry on the same side. Laboratory investigations on admission revealed normal hematological levels apart from an elevated white blood cell count of 16.24x109/L and an elevated C-reactive protein of 83. COVID-19 and sputum gene X-pert tests for tuberculosis were negative. A Doppler ultrasound for both limbs was normal. D-dimer levels were within normal. A chest X-ray, an electrocardiograph, an echocardiogram, and a computed tomography pulmonary angiogram were performed (Table 2). Of note, the latter revealed a unilateral pleural effusion on the right side. The patient was admitted to the ward for new-onset PPCM in cardiac failure and was started on the medications summarized in Table 3. On day seven of admission, the patient was doing well and was weaned off oxygen. Her cardiac function improved over a period of one week and her ejection fraction had improved to 58% and was discharged. She remains well to date.