Case 33422

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Abstract
Presentation of CaseA seven-year-old boy was admitted to the hospital with extreme dyspnea.About five weeks prior to admission the child began to complain of dyspnea on exertion. Ten days later vomiting, diarrhea and pain in the right upper quadrant developed, and he began to have rapid, grunting respirations. He was admitted to another hospital, where examination revealed myocardial enlargement in all diameters, with a faint systolic murmur at the apex and an enlarged tender liver. The blood pressure was 80 systolic, 60 diastolic. During the hospital stay the temperature remained normal, and the sedimentation rate was not elevated. . . .

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