Case 4-1973

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Abstract
Presentation of CaseA 21-year-old woman was admitted to the hospital for cardiac catheterization.She had had multiple arthralgias most of her life. Ten years previously there was the onset of Raynaud's phenomenon, complicated by the development of ulceration and infection of the fingertips. Six years before entry she was admitted to another hospital because of arthralgias, fever, pleuritic pain and a malar rash. A diagnosis of rheumatic fever was made; she was given penicillin and prednisone and was placed on limited activity for one year. Four years before admission she began to experience progressive exertional dyspnea accompanied by occasional . . .

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