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DR. FRANK GLENN: The patient for today 's discussion presented sonme particularly interesting and challenging problems when she was first seen at The New York Hospital in November 1954. I am going to ask our panel to review with you the ideas and considerations that confronted us in the diagnosis and management of this patient's heart disease. Dr. Engle, will you please give us the history ? DR. MARY A. ENGLE: The patient, a 27year-old married woman, was admitted for evaluation of coarctation of the aorta. From her and from the physicians who took care of her from infancy we obtained the following information. She was born 1 month prematurely. Because she failed to thrive, she was taken to a pediatrician at the age of 51/2 months. He discovered a loud systolic murmur all over the precordium and in the lung fields. The aortic and pulmonic second sounds were distinct, and there was iio precordial bulge. Fluoroscopy disclosed enlargement of the left ventricle. These findings remained unchanged throughout infanuv and childhood and she was considered to have a ventricular septal defect. Failure to thrive was most marked during the first year. After the age of 2, however,

Coarctation of Aorta Complicated by Bacterial Endocarditis and an Aneurysm of the Sinus of Valsalva