Clinical Introduction An 82-year-old man with a history of coronary artery bypass surgery, hypertension and small bowel gastrointestinal stromal tumour underwent cardiac risk evaluation prior to surgical resection of his tumour. He was asymptomatic from a cardiovascular perspective, but his activity level was less than four metabolic equivalents. Physical examination was notable for a 2/6 systolic murmur at the apex. ECG showed sinus rhythm. A transthoracic echocardiogram was performed (figure 1 and online supplementary video 1).
Supplementary file 1
QUESTION: The findings in figure 1 are most likely due to which of the following?
Atrioventricular conduction block.
Acute severe aortic regurgitation.
Patent ductus arteriosus.
Severe mitral stenosis.
- valvular heart diseas
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Contributors All listed authors participated in the drafting of the submitted work and fulfil criteria for authorship. DFK: case review, manuscript planning and drafting. KA and JL: case review, manuscript drafting and critical review.
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 Not required.
Provenance and peer review Not commissioned; externally peer reviewed.