case | dyspnoea

File:Treponema pallidum 01.png

Every now and then in medicine, you’ll see an image so astounding that it will stick in your mind. It doesn’t always have to be in the middle of a complex operation or with some rare investigation – even the humble chest X-ray can bring some pretty impressive results.

Check out this set of images in NEJM, of a 76 year old man with progressive exertional dyspnoea and a murmur of aortic regurgitation on examination. If you know what the picture above is showing, then you already know the answer.

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