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Dr. Claudia U. Chae: A 75-year-old woman was admitted to the hospital because of chest pain. One week before admission she had had an illness characterized by fever, headache, nausea, malaise, and anorexia. On the night before admission, she awoke with a sensation of heaviness in her chest, dyspnea, and sweating, without nausea, vomiting, palpitations, or syncope. There was no improvement with the administration of sublingual nitroglycerin. She was admitted to the hospital.
The patient had had exertional chest pain for several years, which had been treated and controlled with sublingual nitroglycerin. Forty months before admission, a cardiac ultrasonographic study
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From the Division of Infectious Diseases, Beth Israel Deaconess Medical Center (A.W.K.); the Divisions of Cardiac Surgery (D.F.T.), and Cardiology (C.U.C., N.A.A.), and the Department of Pathology (S.L.H.), Massachusetts General Hospital; and the Departments of Surgery (D.F.T.), Medicine (C.U.C., A.W.K., N.A.A.), and Pathology (S.L.H.), Harvard Medical School all in Boston.
Related Letters:
Case 29-2004: A Woman with Acute Onset of Chest Pain and Fever
Medford A. R.L., Chae C.
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N Engl J Med 2005;
352:309, Jan 20, 2005.
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