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A young man with acute heart failure and a holodiastolic murmur
  1. Venkatakrishnan Ramakumar,
  2. Balaji Arvind,
  3. Siddharthan Deepti
  1. Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
  1. Correspondence to Dr Siddharthan Deepti, Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India; deeptikailath{at}

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Clinical introduction

A young man in his 20s presented to the emergency department with a 2-week history of dyspnoea and fever. His medical history was remarkable for recurrent episodes of fever with arthralgia in childhood f. Clinical examination revealed pedal oedema, bounding pulses and a holodiastolic murmur. Additionally, chest auscultation revealed bibasilar crackles. The ECG showed sinus tachycardia with features of left ventricular volume overload. Two-dimensional transthoracic echocardiography was performed and …

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  • Contributors All authors were involved in patient care, conceptualisation, drafting and revision of 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, conduct, reporting or dissemination plans of this research.

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