Dyspnoea and murmur in a young adult

Clinical introduction A quadragenarian patient presented with functional class II dyspnoea for 6 months. Clinical examination revealed cardiomegaly, left ventricular S3 with 4/6 systolic murmur at cardiac apex, radiating towards the base of the heart. The mitral inflow continuous Doppler and lateral mitral annular tissue Doppler imaging are shown in figure 1A,B. Figure 1(A) Transthoracic 2D echocardiogram showing mitral inflow continuous wave Doppler; (B) lateral mitral annular tissue Doppler imaging. Question What is the most likely aetiology of the patient’s murmur? Rheumatic mitral valve disease, Systolic anterior motion of anterior mitral leaflet, Myxomatous mitral valve disease with mitral valve prolapse, Mitral leaflet perforation due to infective endocarditis Answer: C The patient had normal left ventricular function with a thickened myxomatous mitral valve with mitral annular disjunction (figure 2A,B). It was...
Source: Heart - Category: Cardiology Authors: Tags: Image challenges Source Type: research