Case 46381

Abstract

Presentation of CaseAn eighty-one-year-old woman consulted her physician over a period of nine months because of gradually increasing exertional dyspnea.Nineteen months before the onset of dyspnea, when she was asymptomatic, physical examination showed moist, crackling rales at both lung bases. There was no history of hypertension, and the patient never used nose drops or mineral oil. An electrocardiogram (Fig. 1) showed a normal sinus rhythm at a rate of 90; the PR and QRS intervals were 0.12 and 0.07 seconds, respectively; the axis was 0°; the limb leads and Leads V₂, V₄ and V₆ . . .