Case 38111

Presentation of CaseA fifty-two-year-old woman entered the hospital because of dyspnea and swelling of the legs.One and a half years prior to admission the patient had an episode of severe substernal pain for which she was put to bed for two weeks. Following this attack she developed peripheral edema, cyanosis of the finger tips, gradually increasing dyspnea and some orthopnea. In spite of digitalis, diuretic pills, intravenous mercurial diuretics and limitation of activity, the symptoms persisted.She stated that as a child she had always been weaker than her playmates, having been unable to keep up with their . . .