Clinical History 294

Forty-four year old woman with rheumatic heart disease status post bioprosthetic aortic and mitral valve replacements three years priorto this electrocardiogram who returns for outpatient cardiology follow-up evaluation. Co-morbidities include hypertension and a seizure disorder. Her medications included furosemide, potassium, warfarin, enalapril, carbamazepine and digoxin.
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