Case history
Case history #1
A 36-year-old prima gravida presents with dyspnoea on exertion and two-pillow orthopnoea (requiring two pillows at night to alleviate recumbent dyspnoea) during her second trimester. Previous physical examinations had disclosed no cardiac abnormalities. On current physical examination she has a loud first heart sound and a 2/6 diastolic rumbling murmur.
Case history #2
An 83-year-old man presents with progressive dyspnoea on exertion over the past year. He is frail and his activities are limited but he notes difficulty climbing five stairs to access his front door. He complains of two-pillow orthopnoea. On physical examination his neck veins are elevated. No murmur is heard.
Other presentations
May present with atrial fibrillation, heart failure, or systemic embolism.
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