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November 1977

Postmyocardial Infarction Complications Requiring Surgery

Author Affiliations

From the Department of Medicine, Jewish Hospital of St Louis, and Washington University School of Medicine, St Louis.

Arch Intern Med. 1977;137(11):1580-1586. doi:10.1001/archinte.1977.03630230064016

Henry Mattis, MD, Junior Assistant Resident, The Jewish Hospital of St Louis: A 49-year-old man was hospitalized because of retractable congestive heart failure following a recent myocardial infarct with a chief complaint of dyspnea. The patient had enjoyed good health until Nov 6, 1976, when he noted a prolonged bout of epigastric discomfort associated with diaphoresis and nausea during a deer hunting trip. He did not consult a physician at that time, but one week later he went to a local hospital with complaints of dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and edema. At that time, he had no chest or abdominal pain. He was noted to be in pulmonary edema and had a new systolic murmur and an inferior infarct by ECG analysis. He had been examined three months earlier and had a normal ECG and no murmur. His congestive heart failure was refractory to digitalis, high doses of furosemide

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