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A 73-year-old man with insulin-dependent diabetes mellitus and a history of coronary artery disease came to the emergency department because of chest pain of one hour's duration that radiated to the jaw and back, shortness of breath, diaphoresis, and a nonproductive cough. The pain was similar to the angina he usually experienced, except for an intermittent pleuritic component with accompanying discomfort on the right side of the chest. An electrocardiogram showed right bundle-branch block with T-wave inversion in leads V1
Commentary
Source Information
From the Beth Israel Deaconess Medical Center, Boston.
Address reprint requests to Dr. Zaleznik at the Infectious Diseases Division, Beth Israel Deaconess Medical Center, East Campus, SL-435, 330 Brookline Ave., Boston, MA 02215, or at dzalezni@caregroup.harvard.edu. Lisa H. Underhill, M.S., assisted with the preparation of this article.
References
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