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This chapter presents the patient study data of a chronic alcoholic patient who was hospitalized for exertional dyspnea in 1968. He was told of a heart murmur at age 20 in 1939 and has had dyspnea on exertion since that time. He has had two admissions for heart failure, in 1962 and 1964. The patient was offered surgery in 1966 for hypertrophic subaortic stenosis but refused. He was treated with the...
This chapter presents the patient study data of a 54‐year‐old black male admitted to hospital in 1975 with dyspnea for 2 months. It provides the history, lab test results and results of the physical examination. He had a life‐long history of a heart murmur but no history of rheumatic fever or hypertension. He was a drinker and an occasional smoker. He was diagnosed with a moderate‐sized PDA with moderately...
This chapter presents the study of a 20‐year‐old man admitted to hospital with atypical chest pain in 1979. It provides the history, physical examination, diagnosis and treatment and follow‐up data of the patient. The patient had had a small VSD since age 3 and developed aortic regurgitation at age 20, with a moderately elevated regurgitant fraction of 51%. At surgery in 1979 the VSD was in fact large...
This chapter presents the study of 23‐year‐old black female nullipara admitted to hospital with 3‐week history of progressive dyspnea on exertion, paroxysmal nocturnal dyspnea, and leg edema. She was told that she had had heart murmur and scarlet fever at age 11. She underwent a surgical procedure in January 1975. She was readmitted to assess the efficacy of open‐heart surgery after one year. She...
This chapter presents the patient study data of a 24‐year‐old man admitted to hospital with a 1‐day history of fever and right leg pain and following a recent tooth extraction. It provides the history, physical examination, laboratory data, and the course of treatment. The patient, a former drug addict, had a streptococcal septicemia that lead to aortic valve endocarditis and a septic embolism to...
This chapter presents the patient study data of a 21‐year‐old man admitted to hospital with hemoptysis for one day. It provides the diagnosis, history, physical examination, laboratory data, and additional angiographic data of the patient. The patient had an upper respiratory tract infection for the last 4 weeks and mild impairment of exercise tolerance. He was diagnosed with a heart murmur at age...
This chapter presents the study of a 40‐year‐old man admitted to hospital in 1975 with a history of dyspnea and edema for 3 months. It provides the hemodynamic data, history, laboratory data, course and treatment details of the patient. The patient had severe mitral regurgitation, presumably due to degenerative myxomatous mitral valve disease in 1975. At surgery, in 1979, three of the chordae of the...
This chapter presents the patient study data of a 17‐year‐old female admitted to hospital with a 6‐month history of fatigue and dyspnea on walking two blocks. It provides the history, physical examination, laboratory data, and the course of treatment of the patient. The patient was only mildly symptomatic but had the findings of ASD, i.e. wide fixed splitting of the second sound and a pulmonary flow...
This chapter presents the patients study data of a 37‐year‐old man admitted to hospital in 1998 with a history of dyspnea on walking half a mile or up two flights of stairs for the last 6 months. It provides the history, physical examination, laboratory data, diagnosis, and the course of treatment of the patient. The patient used to run 6 miles without difficulty. He had scarlet fever as child but...
This chapter presents the patients study data of a 27‐year‐old female admitted to hospital in 1996 with new onset of dyspnea and paroxysmal nocturnal dyspnea for the last 2 months. It provides the history, physical examination, laboratory data, and the course of treatment of the patient. Two months ago, the patient was noted to have had a heart murmur and atrial flutter on the ECG. A suboptimal echocardiogram...
This chapter presents the patient study data of a 11 months of age first seen in 1967. It provides the history, physical examination, laboratory data, and diagnosis of the patient. The patient had a heart murmur at 1 month of age and heart failure at 10 months. He had circumoral cyanosis when he cried. His heart failure improved on digitalis and he was referred for cardiac catheterization in August...
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