Case 4 - A 67 Year-Old Man with Aortic Regurgitation Who Presented Syncope Followed by Shock

In November of 2010, during outpatient care, the patient complained of adynamia, weakness and weight loss in the previous six months and, about one month before the appointment, he had presented gastrointestinal bleeding , for which he needed a blood transfusion. On that occasion, his red blood cell count was 6 g/dL (Table 2). The patient was on acetylsalicylic acid 100 mg, enalapril 40 mg, digoxin 0.25 mg, furosemide 40 mg, potassium chloride 600 mg, ferrous sulfate 2x/day and amitriptyline 25 mg daily.