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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 341:1829-1835 December 9, 1999 Number 24
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Case 37-1999 — A 72-Year-Old Woman with a Prosthetic Aortic Valve and Intracranial Hemorrhage
Johnathan L. Halperin, Stefanie J. Fry, and Stuart L. Houser

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Presentation of Case

A 72-year-old, right-handed woman was admitted to the hospital because of slurred speech and agitation.

The patient had a long history of hypothyroidism, hyperlipidemia, and angina pectoris. Five years before admission, a St. Jude Medical prosthetic valve had been inserted to replace a stenotic aortic valve; a double coronary-artery bypass graft was also performed because of severe, symptomatic coronary artery disease. Warfarin therapy was begun.

Several months before admission, the patient began to eat less and lost a considerable amount of weight. She continued her warfarin therapy. During the three months before admission, she had headaches and dizziness, with increasing . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnoses

Dr. Jonathan L. Halperin's Diagnoses

Pathological Discussion

Anatomical Diagnoses




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