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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 332:1566-1572 June 8, 1995 Number 23
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Case 17-1995— An 81-year-old woman with mitral regurgitation and a left-upper-lobe pulmonary infiltrate
C.A. Hales, and E.J. Mark

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Presentation of Case

An 81-year-old woman was admitted to the hospital because of severe pulmonary edema after aortic-valve and mitral-valve replacements.

The patient had been in good health until four years earlier, when severe dyspnea developed. A cardiac-catheterization study showed that the right atrial pressure was 4 mm Hg, the pulmonary arterial pressure was 28/17 mm Hg, and the pulmonary-capillary wedge pressure was 15 mm Hg. There was severe aortic stenosis, with a peak pressure gradient of 100 mm Hg. The cardiac output was 4.4 liters per minute. Left ventricular function was normal. A coronary angiographic examination revealed 80 percent stenosis of the . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnoses

Dr. Charles A. Hales's Diagnoses

Pathological Discussion

Anatomical Diagnosis

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