【摘 要】
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A 70-year-old female with history of rheumatic fever as a child with resul-tant surgical mitral valve replacement with bioprosthetic valve ten years prior presented to the hospital with worsening shortness of breath of two days duration.Associating sympto
【机 构】
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Internal Medicine,University of Florida Health Jacksonville,Florida,USA;Division of Cardiology,Unive
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A 70-year-old female with history of rheumatic fever as a child with resul-tant surgical mitral valve replacement with bioprosthetic valve ten years prior presented to the hospital with worsening shortness of breath of two days duration.Associating symptoms in-cluded orthopnea,dry cough,and lower extremity edema.In the Emergency Room,the patient was afe-brile and hemodynamically stable;however,she was tachypneic and hypoxic requiring non-rebreather.Physical examination revealed a systolic and dia-stolic murmur 3/5 in intensity heard best at the apex along with bilateral basilar crackles.Labs were significant for an elevated N-terminal prohormone of brain natriuretic peptide.
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