24th July 2020

A 50-year-old lady present to the GP surgery with worsening shortness of breath

A 50-year-old lady present to the GP surgery with worsening shortness of breath. She mentions that she often wakes up at night coughing and on some occasions has coughed up some frothy pink sputum. On examination, she has an irregularly irregular pulse and on auscultation of the heart, you hear a mid-diastolic rumbling murmur which is preceded by an open snap. It is loudest at the apex when the patient is lying on their left side. What is the likely diagnosis? 

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