Case 37-1993

Presentation of CaseA 48-year-old woman was admitted to the hospital because of a secundum atrial septal defect with severe pulmonary hypertension.A murmur was first heard when the patient was 11 years of age. At 21 years she began to experience palpitations during exercise and had auscultatory findings characteristic of an atrial septal defect. Eight years later she was dyspneic when climbing three flights of stairs and had frequent respiratory tract infections. She was seen at this hospital, and the risk of a cardiac surgical procedure was considered unacceptable. At 39 years of age supraventricular tachycardia occurred and responded . . .