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Image challenge
Heart murmur in a young man
  1. Alexander Perry Taylor1,
  2. Deanna Hanson1,
  3. Eric V Krieger2
  1. 1 Division of Cardiology, University of Washington, Seattle, Washington, USA
  2. 2 Cardiac Clinic and Services, University of Washington Medical Center, Seattle, Washington, USA
  1. Correspondence to Dr Eric V Krieger, Seattle Adult Congenital Heart Sercie. Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195-6422, USA; ekrieger{at}u.washington.edu

https://doi.org/10.1136/heartjnl-2020-318834

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    Clinical Introduction

    A man in his 20s with Down syndrome presented to cardiology clinic for evaluation of a murmur. He denied symptoms. He had no prior history of invasive cardiac procedures or cardiac surgery. His examination revealed a murmur. An echocardiogram was performed and a diagnostic image is shown in figure 1.

    Figure 1

    Colour M-mode echocardiographic image of the mitral valve.

    Question

    1. Based on the colour Doppler M-mode echocardiographic image (figure 1), what is the most likely cause …

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    Footnotes

    • Contributors APT drafted the initial manuscript, which was reviewed and edited by EK. DH obtained the echocardiographic image and reviewed the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.