This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Peter J. Engel, MD; Herbert D. Long, Jr, MD; David Eppert

Arch Intern Med. 1981;141(6):775-777.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

A 33-year-old woman had undergone aortic and mitral valve replacement with Björk-Shiley prostheses in 1973 because of rheumatic valvular disease. She has been receiving digoxin and warfarin sodium since then. In November 1978, she noted the gradual onset of exertional dyspnea and orthopnea, which prompted her admission to the hospital. Physical examination disclosed a regular heart rate of 96 beats per minute, blood pressure of 120/70 mm Hg, and a grade 3/6 midsystolic murmur at the apex. A third sound of variable timing was noted. The ECG indicated left ventricular hypertrophy and left atrial enlargement only. A chest roentgenogram was compatible with congestive heart failure. Figure 1 is a simultaneous recording of the ECG, apical phonocardiogram (PCG), and mitral prosthetic valve echogram (PVE).

What is your diagnosis?

Diagnosis.

—Malfunction of Björk-Shiley Mitral Prosthesis.

Figure 2 is a higher paper-speed recording of the same graphics as in Fig 1. Note . . . [Full Text PDF of this Article]

Author Affiliations
From the Division of Cardiology, Department of Medicine, University of Cincinnati Hospitals (Dr Engel and Mr Eppert); and the General Division, Jewish Hospital (Dr Long), Cincinnati.

Footnotes
Accepted for publication June 3, 1980.

Reprint requests to Division of Cardiology, University of Cincinnati College of Medicine, 231 Bethesda Ave, MSB 3354, Cincinnati, OH 45267 (Dr Engel).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?