Case 71


An 82-year-old female patient with history of diabetes, arterial hypertension, gastroesophageal reflux disease, severe mitral stenosis and pulmonary hypertension due to recurrent thromboembolic events complained of a retroesternal pain. She reported it as a nocturnal burning sensation which had begun a month before. She sought medical assistance and underwent an upper gastroduodenal endoscopy (mild esophagitis, no significant alterations), an exercise treadmill test and a myocardial perfusion scintigraphy at rest / on pharmacologic stress. Two days later she developed acute pulmonary edema and had to undergo a cineangiocoronariography.


Based on the video and images provided, we can assume that her clinical history was most compatible with:

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