Isolated pulmonic valvular regurgitation.

Vr. H., a 20ear-old Negro housewife, was apparently norimnal at birth except for small supernumeraryl digits on eaich of her 4 extremities. As a child she was able to keel) up with other children until her early teens when she noted easy fatigabilitv on moderate exertion and inability to run because of dvspnea and marked dizziness. At 15 years of age she had pleurisy an(l shortness of l)reathi for about 2 months. When seca by a physician, she was tol(l that she had 'l'earit trouble probably from birth." Shortly thereafter she had severe tonsillitis, but no rheumatism, chorea, or other stigmata of rheumiatic fever. Her first p)regnnIiicNy at 1 5 years of age termninated spontaneously at 3 months. During her second pregnancy at 20, moderate exertional lsplnea was noted, but deliverv of a normal male infant was tolertated without evi(leace of heart failure. The patient hall her first complete physical examination 3 months after her second p)regnancy, wlhen she developed cough, fever, and pleurisy of the right chest. In addition to evidence of pneunionitis, she was note(l to have a heart murmur. After the pneumionitis responnledl to antibiotics, the patient w-as referred to the Cardiovascular Clinic of the City of Memphis Hospitals because of her murmur, mild dyspneta on exertion, and dhizziness on moderate exertion. The patient was normally developed. There was no dyspnea, cyanosis, or clubbing of the fingers. The pulse was 72 and the blood pressure 110/70. There