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Chest pressure and dyspnoea in a 47-year-old man
  1. Sushan Yang,
  2. John K Feller,
  3. Eric Krieger
  1. Cardiology, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Sushan Yang, Cardiology, University of Washington, Seattle, WA 98195, USA; susany90{at}

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Clinical introduction

A 47-year-old man presents with exertional dyspnoea and chest pressure. He also reports occasional palpitations and postural syncope. Cardiovascular exam is notable for a blood pressure of 116/76 mm Hg, regular rate and rhythm, normal S1 and S2, with no jugular venous distension and no oedema. A murmur is noted. ECG shows left ventricular hypertrophy and repolarisation abnormalities. A transthoracic echocardiogram was obtained, and an M-mode recording of the mitral valve is …

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  • 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 consent for publication Not required.

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