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Dr. David S. Frankel (Medicine): A 72-year-old woman was admitted to this hospital because of respiratory failure and hypotension.
During the week before admission, the patient and other members of her family had symptoms of an upper respiratory tract infection. Five days before admission, the results of a routine annual checkup by her primary care physician were normal. Two days before admission, she awoke early in the morning with severe, intractable nausea and anorexia, without vomiting or diarrhea. During the next 24 hours, the symptoms worsened; a cough developed that was initially dry and was later productive of yellow sputum.
Differential Diagnosis
Mechanical Causes of Cardiogenic Shock
Extensive Ischemia or Infarction
Endocarditis
Clinical Diagnosis
Dr. Paula A. Johnson's Diagnosis
Pathological Discussion
Discussion of Management
Risk Assessment and Modification
Symptoms of Coronary Artery Disease and Myocardial Infarction
Postinfarction Care
Anatomical Diagnosis
Source Information
From the Division of Women's Health, Brigham and Women's Hospital (P.A.J.); the Cardiology Division (F.A.J., T.G.N.) and the Departments of Radiology (J.-A.O.S.) and Pathology (J.R.S.), Massachusetts General Hospital; and the Departments of Medicine (P.A.J., F.A.J., T.G.N.), Radiology (J.-A.O.S.), and Pathology (J.R.S.), Harvard Medical School — all in Boston.
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