Case 43-1971

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Abstract
Presentation of CaseA 70-year-old woman was transferred from another hospital because of persistent congestive heart failure.Seven years previously she was found to have diabetes mellitus, and a diabetic diet and tolbutamide were begun. Five years before admission she had a single, transient episode of left-sided weakness. One year later there was the onset of dyspnea. Two years before admission a film of the chest was normal except for questionable evidence of pulmonary venous hypertension. Three months before entry the dyspnea increased in severity, with the development of peripheral edema, abdominal distention and palpitation. Five weeks before admission she . . .
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