Case 31451

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Abstract
Presentation of Case First admission. A fifty-one-year-old man entered the hospital complaining of shortness of breath.Two years before admission, after lifting a heavy object, he had an attack of severe dyspnea lasting about thirty minutes. Six months before admission he had a similar attack after undue exertion. Four months later sporadic dyspnea on moderate exertion appeared and gradually became severer. Orthopnea and ankle edema developed. Three days before admission he was seized with a severer attack of dyspnea than he had ever had, and it persisted until admission. Orthopnea, insomnia and a nonproductive cough were present. The abdomen increased . . .
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