ABSTRACT
This chapter presents a case study of a 76-year-old white man, who was born on March 3, 1930, and died on April 6, 2006, was apparently in his usual state of health until 1979, when at age 49 he had an acute myocardial infarction. In 1995, at age 65, chronic obstructive pulmonary disease was diagnosed and a left upper lobe noncancerous infiltrate was found and resected. In March 2006 (age 76), the patient's chronic mild dyspnea worsened, a cough productive of green sputum developed, and he was hospitalized on March 21. Transthoracic echocardiography demonstrated normal left ventricular function despite posterior wall hypokinesis and mild to moderate mitral regurgitation and tricuspid regurgitation. Left ventricular angiogram showed mild posterior wall hypokinesia, and severe (4+/4+) mitral regurgitation. Coronary bypass and mitral valve repair had been planned, but the patient arrested in the operating room before the operation was started.
