Case 44-1974

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Abstract
Presentation of CaseA 46-year-old woman was admitted to the hospital because of rheumatic heart disease.Between six and 18 years of age she had 18 episodes of rheumatic fever. At the age of 32 years digitoxin therapy was begun because of atrial fibrillation. Seventeen months before admission she entered another hospital for treatment of congestive heart failure. Cardiac catheterization revealed severe mitral regurgitation and moderate aortic regurgitation.The patient complained of moderate fatigue and dyspnea, with occasional edema and chest pain. There was no history of cough, wheezing, orthopnea or hemoptysis.The temperature was 37°C, the pulse 96 and . . .
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