Case 34141

Abstract
Presentation of CaseA seventy-one-year-old man was admitted to the hospital because of orthopnea and ankle edema.Ten years before entry he was treated in the Out Patient Department for late syphilis. Because of his age he was given bismuth only, and the blood Hinton test became negative. An x-ray film of the chest showed an enlarged heart and a tortuous aorta, with calcification of the aortic knob. Six years before entry he began to have dyspnea on exertion, and physical examination revealed an enlarged heart, with a regular rhythm, a soft apical systolic murmur (Grade II) and a soft . . .

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