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A woman in her 60s presented to her cardiologist with a history of dyspnoea, fatigue and peripheral oedema.
On physical examination, blood pressure was 95/60 mm Hg, heart rate 88 beats/min, respiratory rate 20 per minute, and room air oxygen saturation 90%.
Auscultation in left lateral decubitus of the apex revealed S1 with splitting. Clear systole, S2 was accompanied by a mitral opening snap with early diastolic rumble that ended with a presystolic murmur. These findings were modified by changes in position.
It was decided to perform an echocardiogram that revealed a mobile mass in the left atrium dependent on the interatrial septum, which moved towards the cavity of the …
Contributors All authors have contributed significantly to the conception, design, writing and review of this 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.
Provenance and peer review Not commissioned; internally peer reviewed.
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