title: ECG Case of the Month: Heart Failure in a Man from Chile.
abstract: A 49-year-old man visiting New Orleans from Chile comes to the hospital complaining of exertional dyspnea for 2 months with the more recent onset of ankle edema. He is a slender man with a blood pressure of 91/60 mmHg, crackles at both lung bases, and markedly distended neck veins. His cardiac rhythm is irregular. A soft murmur of mitral regurgitation and a soft S-3 are heard at the left ventricular apex. All four pedal pulses are easily palpable. Epigastric tenderness is noted on palpation; although the patient has a history of peptic ulcer disease, the tenderness is probably due to an enlarged left lobe of his liver, the result of hepatic congestion from his heart failure. A chest radiograph shows generalized cardiomegaly with an especially large left ventricle. Pulmonary congestion and small bilateral pleural effusions also are noted. The Figure shows the electrocardiogram recorded on admission.
authors: Professor of Medicine (cardiology) at Louisiana State University Health Sciences Center in New Orleans, LA.
authors: D Luke
authors: DL
authors: Glancy
authors: Glenn A
authors: GA
authors: Cochran
authors: Department of Medicine at Louisiana State University Health Sciences Center in New Orleans, LA.
authors: Frederick R
authors: FR
authors: Helmcke
mesh_terms: D018618:Echocardiography, Doppler, Color / Q000379:methods*; D004487:Edema; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged