1st April 2022

A 62-year-old man presents to his GP with worsening shortness of breath on exertion

A 62-year-old man presents to his GP with worsening shortness of breath on exertion. He wakes up at night coughing and needs 3 pillows to sleep. On examination, he has an irregularly irregular pulse, and a pansystolic murmur, best heard in 5th left intercostal space, mid clavicular line. This murmur can also be heard in the axilla. Bilateral basal crepitations can be heard on auscultation of the lungs, and he has bilateral pitting oedema of the ankles. His observations are as follows:

HR 100, BP 131/95, RR 18, SpO2 95% on air, Temp 37.3oC

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