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FUNCTIONAL DIASTOLIC MURMURS AND CARDIAC ENLARGEMENT IN SEVERE ANEMIAS

BERTRAM GOLDSTEIN, M.D.; ERNST P. BOAS, M.D.
Arch Intern Med (Chic). 1927;39(2):226-232. doi:10.1001/archinte.1927.00130020065005.
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The occurrence in patients with pernicious anemia of fatty infiltration of the heart manifested at the necropsy table by the so-called "tigering" of the heart muscle is well known. Dilatation of the heart as well as the presence of so-called "hemic" systolic murmurs are also matters of common observation. These changes are of little clinical interest or importance, so that ordinarily but slight attention is paid to the heart in patients with this disease. The following two cases of pernicious anemia, which presented classical physical signs of chronic valvular heart disease, but in which at necropsy the valves were normal in every respect, illustrate a cardiovascular symptomatology in pernicious anemia which deserves more attention, for it is not unusual.

Case 1.—G. S., a woman, aged 29, entered Montefiore Hospital, Oct. 5, 1925, with the diagnosis of pernicious anemia. She had been sick for about one year, complaining chiefly of weakness.

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