Case 20-1982 — A 42-Year-Old Woman with Ulcerative Colitis, Dyspnea, and Edema

Presentation of CaseA 42-year old woman was admitted to the hospital because of dyspnea and edema.There was a history of ulcerative colitis of 19 years' duration. Several episodes of activity had been treated with adrenocorticosteroids and sulfasalazine. Two months before entry she began to have bouts of irregular cardiac rhythm that lasted 15 to 30 seconds. A physician found no abnormality on physical examination. An electrocardiogram revealed incomplete right-bundle-branch block. Periodic sigmoidoscopic examination disclosed evidence of mildly active colitis. The patient was advised to discontinue caffeine and felt improved. One month before admission she became fatigued and experienced . . .