Case 39-1979: A 50-Year-Old Man with Biventricular Failure

Presentation of Case A 50-year-old man was admitted to the hospital because of biventricular failure. A heart murmur was discovered at the age of six years, and he became intolerant of exercise in his teens. At 33 years of age he was seen at this hospital, where a diagnosis of patent ductus arteriosus was made. He declined further investigation and surgical repair. At the age of 44 years he became dyspneic at rest and experienced the acute onset of severe respiratory distress. He returned to this hospital, where examination revealed atrial fibrillation and evidence of pulmonary edema. Digitalis and diuretic.