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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 329:864-872 September 16, 1993 Number 12
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Case 37-1993— A 48-Year-Old Woman with an Atrial Septal Defect and Pulmonary Hypertension
Robert L. Geggel, and Eugene J. Mark

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Presentation of Case

A 48-year-old woman was admitted to the hospital because of a secundum atrial septal defect with severe pulmonary hypertension.

A murmur was first heard when the patient was 11 years of age. At 21 years she began to experience palpitations during exercise and had auscultatory findings characteristic of an atrial septal defect. Eight years later she was dyspneic when climbing three flights of stairs and had frequent respiratory tract infections. She was seen at this hospital, and the risk of a cardiac surgical procedure was considered unacceptable. At 39 years of age supraventricular tachycardia occurred and responded to verapamil; diltiazem . . . [Full Text of this Article]

Differential Diagnosis

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Dr. Robert L. Geggel's Diagnoses

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