Case 49-1965

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Abstract
Presentation of CaseA seventy-eight-year-old woman was admitted to the hospital because of weakness.She had been well until four years previously, when fatigue and anemia developed. Stool specimens gave positive guaiac tests, but no source of bleeding was demonstrated. Six months later she entered the hospital because of the abrupt onset of diplopia. Physical examination disclosed palsy of the right abducens nerve, a murmur indicative of aortic stenosis and enlargement of the heart. A heart murmur had been audible since the age of fifty-eight years. An electrocardiogram (Fig. 1 ) showed a pattern of left ventricular strain. X-ray films with . . .

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