A 74-year-old woman presented to her GP with shortness of breath and swelling upon exertion. Patient History: She has a story of rheumatic fever while in her twenties. She also noted that the typical swelling she's had in her ankles for years has started to get worse over the past two months, making it especially difficult to get her shoes on toward the end of the day. In the past week, she's had a decreased appetite, some nausea and vomiting, and tenderness in the right upper quadrant of the abdomen. Physical Examination: On examination, patient`s jugular veins were noticeably distended.
Auscultation of the heart revealed a low-pitched, rumbling systolic murmur, heard best over the left upper sternal border. In addition, she had an extra, "S 3 " heart sound. What is the causative factor for the murmur and the “S 3 ” sound? This patient case is from Docplexus Editorial Team for…
