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 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 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 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 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 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 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 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 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…
Diabetes, Hypertension, and Hypercholesterolemia A 54-year-old man has diabetes, hypertension, and hypercholesterolemia. He complains of dyspnea on exertion and has limited his activities. A stress test showed no evidence of…
