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Dyspnoea in a cancer patient
  1. Thomas S Metkus,
  2. Theodore Abraham
  1. Division of Cardiology, Johns Hopkins Hospital, Baltimore, Maryland, USA
  1. Correspondence to Dr Thomas S Metkus, Division of Cardiology, Johns Hopkins Hospital, 1800 Orleans St/Zayed 7125, Baltimore, MD 21287, USA; tmetkus{at}jhmi.edu

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Clinical Introduction

A 32-year-old woman with a history of adenocarcinoma presents with progressive dyspnoea evoked by activities of daily living, lower extremity oedema, and abdominal bloating and distention. An echocardiogram is performed with M-mode and Doppler images shown in Figure 1.

Figure 1

(A) M-mode at the mid-ventricular level. (B) Pulsed wave Doppler of mitral inflow. (C) Tissue Doppler of the medial mitral annulus. (D) Tissue Doppler of the lateral mitral annulus.

Question

What finding would you expect to find on physical examination?

  1. Friction rub

  2. Large V waves …

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