Case 42352

Abstract
Presentation of CaseAn eighty-three-year-old man was admitted to the hospital because of abdominal pain.During the day before entry there was a sudden onset of severe, persistent abdominal pain that caused him to collapse on the next day.Four years previously he had a pneumococcal pneumonia of the left lower lobe that was successfully treated with penicillin. At that time cardiac enlargement and atrial fibrillation were noted. The blood pressure was 120 systolic, 60 diastolic. An electrocardiogram showed atrial fibrillation, left-axis deviation and minor T-wave changes. He subsequently remained in good health and took digitalis regularly. There was no . . .

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