Case 39011

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Abstract
Presentation of CaseA seventy-six-year-old woman was admitted to the hospital because of progressive weakness.Ten years previously the patient noted the onset of slight exertional dyspnea and edema of the legs; the latter was usually worse in the evening and disappeared by morning. Both symptoms gradually became more marked, and were most troublesome during the year prior to entry. Digitalis was prescribed by her physician, and the symptoms improved although ankle edema tended to recur. Three years before admission progressive weakness developed. Despite these symptoms the patient was active, although limited to some extent by poor vision, until one . . .