hello and thank you for asking HCM, I understand your concern. Tiredness is common in pregnancy, esepcially in the last part of it. But regarding to what you have written that she has murmur and high pulse, she should visit a cardiologist, because tiredness and high pulse can be a sign of worsening of her murmur. During pregnancy blood volume is usually increased, which could also affect and worsen the murmur and cause high pulse. This is a condition which should be checked by a cardiologist to see if any kind of therapy is necessery. Until you visit a cardiologist, tell your daughter to avoid any kind of physical exhaustion. I hope this answer was helpful to you.