Case 7-1963

Presentation of Case* First admission. A sixty-nine-year-old man was admitted to the hospital because of weakness and loss of weight.Four months before admission, while on vacation, the patient experienced the onset of dyspnea and fatigue. He was told that he had a heart attack and was given digitalis, which partially relieved the symptoms. Hypertension had been present for several years; three months before entry the blood pressure was 180 systolic, 110 diastolic, and an electrocardiogram was said to show left ventricular hypertrophy and premature ventricular contractions. Hydrochlorothiazide and reserpine were given, and digitalis therapy was resumed. Increasing fatigue, malaise . . .