Case 48-1970

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Abstract
PRESENTATION OF CASEA 45-year-old woman was admitted to the hospital because of a changing cardiac murmur.At the age of 17 years she had been informed that she had a heart murmur. No restrictions were imposed upon her, and she underwent two eventful pregnancies at 23 and 26 years of age. Ten years before admission she began to have episodes of pallor and cyanosis of the hands on exposure to cold; cyanosis was never observed elsewhere. Eight months before entry she was informed that she had hypertension, and treatment with hydroclorothiazide and spironolactone was begun. Three months before admission . . .
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