Congestive Heart Failure of Unusual Cause Affecting a Young Woman; Sudden Death

of Case. A. S., a 28 year old nulliparousNegro housewife was admitted for the seventh time to the Medical Service of Cleveland CityHospital on March 29, 1949, with the complaint of severe, progressive dyspnea of three days' du- ration. She died on the third hospital day. The patient was first hospitalized at age 14 (1935) becauseof gonococcal urethritisandcervicitis. At this time the heart was normal. During this hospitalization the patient developed transient pain and tenderness in the right temporomandibular joint. Concurrently a small ulcer and a condylomaappeared on the left labium minus near the anus. Dark field preparations were positive for Treponema pallidumn, and the blood Wassermann reaction was negative. Healing of the lesions followed a series of14 intravenous injections of Mapharsen and a course of bismuth. She was readmitted for five days one month following discharge, because of pain and swelling of the right knee joint. These abated after symptomatic management.The