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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.
An 81-year-old woman presented to the emergency department with increasing abdominal distention, nausea, and vomiting. She also reported increasing shortness of breath and fatigue, which had become worse over the past several weeks. She had a history of congestive heart failure, mitral regurgitation, hypertension, atrial fibrillation, hypothyroidism, peptic ulcer disease, and depression. She had no history of coronary artery disease or cardiac
Commentary
Source Information
From the Duke University Medical Center, Durham, NC.
Address reprint requests to Dr. Kong at mh21@duke.edu.
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