ABSTRACT
This chapter presents a case study of a 71-year-old white man, who died on September 1, 1969, was admitted to Georgetown University Hospital on August 3, 1969, because of recurrent fever for three weeks and exertional dyspnea for one week. Examinations during the previous three weeks disclosed rales at both lung bases, considered the result of viral pneumonitis, and he was treated with tetracycline. Despite anorexia, he gained 3.7 kg during the week before admission. He denied chest pain, palpitations, syncope, hemoptysis, systemic hypertension, diabetes mellitus and known hyperlipoproteinemia. Clinical, hemodynamic and anatomic findings are described in a 71-year-old man with “silent” acute myocardial infarction. Hemodynamic evidence of mitral regurgitation resulting from papillary muscle necrosis was obtained both before and after the appearance of the murmur of mitral regurgitation. On admission, he was dyspneic, diaphoretic, tachypneic (45 respirations per minute), and normotensive (110/80 mm Hg). The neck veins were distended and the carotid arterial pulsations were decreased without bruits.
