You are here

Article Text

Article menu
Download PDFPDF
Image challenge
Dyspnoea and murmur in a young adult
  1. Sudipta Mondal,
  2. Vrandha Garikapati,
  3. Saurav Banerjee
  1. Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
  1. Correspondence to Dr Sudipta Mondal, Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, KL, India; sudiptamondalnrs{at}gmail.com

https://doi.org/10.1136/heartjnl-2023-323362

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Clinical introduction

    A quadragenarian patient presented with functional class II dyspnoea for 6 months. Clinical examination revealed cardiomegaly, left ventricular S3 with 4/6 systolic murmur at cardiac apex, radiating towards the base of the heart. The mitral inflow continuous Doppler and lateral mitral annular tissue Doppler imaging are shown in figure 1A,B.

    Figure 1

    (A) Transthoracic 2D echocardiogram showing mitral inflow continuous wave Doppler; (B) lateral mitral annular tissue Doppler imaging.

    Question

    What is the most likely aetiology of the patient’s murmur?

    1. Rheumatic mitral valve disease,

    2. Systolic anterior motion of anterior mitral leaflet,

    3. Myxomatous mitral valve disease with mitral valve prolapse,

    4. Mitral leaflet perforation due to infective endocarditis

    Answer: C

    The patient had normal left ventricular function with a thickened myxomatous mitral valve with mitral annular disjunction (figure 2A,B …

    View Full Text

    Footnotes

    • Twitter @Sudiptanrs

    • Contributors SM (conceptualisation: lead; formal analysis: lead; writing—original draft: lead; writing—review and editing: equal); VG (writing—review and editing: equal); SB (writing—review and editing: equal).

    • 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.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.