Case 43111

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Abstract
Presentation of Case First admission. A nine-year-old girl was brought to the hospital because of epistaxes.Four months previously an appendiceal abscess was drained. At that time examination of the heart showed no enlargement. The rhythm was regular at a rate of 146. The pulmonic second sound was greater than the aortic. The mitral first sound was loud. A high-pitched Grade 3 apical systolic murmur along the left sternal border and a low-pitched Grade 2 apical diastolic murmur were audible. The veins of the neck were not distended, and there was no edema. The hemoglobin was 9.4 gm. per 100 . . .