Case 20-1968

Abstract

Presentation of CaseA fifty-seven-year-old woman was admitted to the hospital because of pain in the chest.Two months before admission there was the onset of episodes of dyspnea and left precordial pressure pain that radiated down the inner aspect of the left arm; the distress was precipitated by exertion. Subsequently, she experienced a heavy sensation in the chest after exertion, associated with sweating. She had no palpitation, orthopnea, nocturnal dyspnea or ankle edema, but complained of a dry cough. On examination one month before admission the lungs were clear; the first and second heart sounds were split; no murmur . . .