7th March 2024

A 56-year-old woman presents with dyspnoea on exertion, fatigue, and episodic palpitations.

A 56-year-old woman presents with dyspnoea on exertion, fatigue, and episodic palpitations. She has no prior medical history. She denies chest pain, orthopnoea, paroxysmal nocturnal dyspnoea, or lower extremity oedema. On physical examination, her jugular venous distension is around 12 cm and her lungs are clear. Cardiac examination reveals a slightly displaced apical impulse with a palpable P2. Cardiac auscultation reveals a III/VI holosystolic murmur at the apex that radiates to the axilla with diminished S1 and P2 greater than A2. What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.