Vasodilators in Heart Failure

Excerpt

To the editor: I read with great interest the paper by Cohn and associates (Ann Intern Med 81:777-780, 1974) on the use of vasodilator therapy in intractable left ventricular failure. I wish to corroborate their findings with an account of one of our cases.

A 52-year-old white man had had scarlet fever at age 18. In May 1973, he was found to have congestive heart failure secondary to papillary muscle dysfunction; he was treated, and his failure was controlled with digoxin and furosemide. In November 1974, the patient noted onset of dyspnea on exertion and paroxysmal nocturnal dyspnea, which gradually