Case 5-1980

Presentation of Case First admission. A 64-year-old woman was admitted to the hospital because of weakness.She was well until 10 years previously, when palpitations occurred, and a physician heard a murmur. Digitalis was prescribed but was soon discontinued by the patient. She slept on two pillows for many years and noticed occasional pedal edema. Two years before admission she began to complain of heartburn. A physician made a diagnosis of a peptic ulcer, without radiographic studies, and prescribed an antacid, with relief of symptoms. Two and a half weeks before admission she began to experience weakness and substernal . . .