Case 37-1972

Presentation of Case A 36-year-old woman was admitted to the hospital because of dyspnea. There was a history of frequent sore throats and questionable scarlet fever in childhood, and she was told in early adolescence that she had a heart murmur. She remained active and free of symptoms until she underwent pregnancy 13 and 10 years before entry, complicated by persistent morning sickness and fatigue. Thereafter she did her housework and held a part-time job. Six years before admission there was the abrupt onset of dyspnea on climbing one flight of stairs or walking three blocks, accompanied by two-pillow orthopnea. . . .

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