Pulmonary Edema and End-Stage Renal Disease
Pulmonary Edema and End-Stage Renal Disease A 61-year-old woman with New York Heart Association classification class III heart failure has a history of pulmonary edema and end-stage renal disease. She…
Worsening Abdominal Bloating
Worsening Abdominal Bloating A 61-year-old retired physician presents with a 6-month history of worsening midepigastric bloating sensation associated with fatigue, diarrhea, and lower extremity edema. He has occasional episodes of…
Coronary Artery Bypass Graft and Aortic Valve Replacement
Coronary Artery Bypass Graft and Aortic Valve Replacement A 61-year-old man with a history of coronary artery bypass grafting and aortic valve replacement presents with worsening fatigue and dyspnea on…
Rapid Atrial Fibrillation
Rapid Atrial Fibrillation A 61-year-old man presents to the emergency room with atrial fibrillation and a rapid ventricular response. After anticoagulation and rate control, a transesophageal echocardiogram (TEE) is performed…
Resection of a Mitral Valve Tumor
Resection of a Mitral Valve Tumor The patient is a 61-year-old man with a 10-year history of end-stage renal disease secondary to diabetes mellitus who is currently on hemodialysis. He…
Stress Echo for Dyspnea on Exertion
Stress Echo for Dyspnea on Exertion A 57-year-old woman is referred for stress echocardiogram for evaluation of dyspnea on exertion (DOE). The images in Figures 41-1, 41-2, 41-3, 41-4 and…
Paravalvular Leak
Paravalvular Leak A 57-year-old man had mechanical mitral valve replacement 3 years ago due to severe mitral regurgitation after endocarditis. Six months later, a significant paravalvular leak was verified, and…
Hypertension and Transient Ischemic Attack
Hypertension and Transient Ischemic Attack A 57-year-old woman from El Salvador has a history of hypertension and transient ischemic attacks. She has an abnormal electrocardiogram shown in Figure 40-1. Figure…
Abrupt Onset Chest Discomfort and Abdominal Pain
Abrupt Onset Chest Discomfort and Abdominal Pain A healthy 56-year-old man was in his usual state of health until he developed the abrupt onset of midsternal chest discomfort and epigastric…
Mitral Valve Repair for Mitral Regurgitation
Mitral Valve Repair for Mitral Regurgitation A 55-year-old man underwent mitral valve repair 3 months ago for symptomatic severe mitral regurgitation. He felt well until last week when he developed…
