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In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows.
A 61-year-old woman was hospitalized with a two-day history of palpitations and dyspnea. She was found to be in atrial fibrillation with a rapid ventricular response, and intravenous diltiazem and a heparin infusion were begun. Her condition improved, but on the third hospital day, she reported feeling weak and nauseated and began passing dark red urine. She did not have a urinary
Commentary
Source Information
From the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore.
Address reprint requests to Dr. Marinopoulos at 601 N. Caroline St., Suite 7143, Baltimore, MD 21287, or at smarino1@jhmi.edu.
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