PT  - JOURNAL ARTICLE
AU  - Daniel F Kupsky
AU  - Karthikeyan Ananthasubramaniam
AU  - James Lee
TI  - Eighty-two-year-old man with a systolic murmur
AID  - 10.1136/heartjnl-2018-313413
DP  - 2018 Nov 01
TA  - Heart
PG  - 1887--1890
VI  - 104
IP  - 22
4099  - http://heart.bmj.com/content/104/22/1887.short
4100  - http://heart.bmj.com/content/104/22/1887.full
SO  - Heart2018 Nov 01; 104
AB  - 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 [SP1.mp4] Figure 1 Transthoracic echocardiography. (A) Mitral valve continuous wave Doppler and (B) tricuspid valve continuous wave Doppler.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.Atrial flutter.Severe mitral stenosis.