Diagnostic Problem

Abstract

S u b je c t:

C.S., married, female, aged 33. Housewife.

Past History:

1. Usual childhood illnesses.

2. Pneumonia on three occasions between the ages of 3 and 5 years.

3. Rheumatic fever, aged 9 years.

4. Tonsillectomy, aged 10 years.

5. Appendicectomy, aged 16 years.

6. The patient had two normal pregnancies, aged 23 and 24 years.

7. Perforation of duodenal ulcer, aged 25 years. — Gastroenterostomy.

8. Gradually progressive exertional dyspnoea began, aged 27.

9. Two miscarriages, aged 28, followed by tubal ligation on the grounds of rheumatic heart disease.

10. Mitral valvulotomy successfully carried out, aged 29, with relief of symptoms.

11. Recurrence of classical acute rheumatism, aged 30.