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A 51-year-old woman with no history of heart disease presented to the emergency room complaining of chest pain of 48 h duration and sudden onset of severe dyspnoea. The blood pressure was 92/60 mm Hg and heart rate was 105 beats per minute. Auscultation showed bilateral inspiratory rales and a grade 3/6 harsh, holosystolic murmur along the left sternal border. …