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Figure 1. A 65-year-old man with a five-year history of uncontrolled hypertension was admitted to the emergency department with pulmonary edema. On admission his blood pressure was 180/110 mm Hg. A chest film showed bilateral pleural effusions as well as pulmonary edema. The electrocardiogram demonstrated left bundle-branch block. Hypertension and pulmonary edema resolved rapidly after treatment with nitroglycerin, furosemide, and morphine. During the first 24 hours of treatment, the levels of cardiac enzymes increased (creatine kinase, 370 U per liter; creatine kinase MB, 31 U per liter; and troponin I, 15.6 U per liter). The electrocardiographic findings remained unchanged. . . . [Full Text of this Article] |