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At an office visit in June 2004, a 49-year-old man reported fatigue, arthralgia, and headache, along with a two-day history of chest pain. The patient had hypercholesterolemia, for which he was taking atorvastatin (20 mg daily) and aspirin (81 mg); he had stopped smoking cigarettes 20 years earlier. The patient reported that his father had died at the age of 71 years of myocardial infarction. Physical examination revealed a pulse of 38 beats per minute. Electrocardiography was performed. What is the diagnosis?
Editor's note: We invite our readers to submit their answers at www.nejm.org/mystery. We will publish the diagnosis . . . [Full Text of this Article] |
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