24th July 2020

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

A 50-year-old lady presents to the GP surgery with worsening shortness of breath. She mentions that she often wakes up at night coughing and some occasions has coughed up some frothy pink sputum. On examination, she has an irregularly irregular pulse and on auscultation of the heart, you here 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 side. An echocardiogram confirms diagnosis, corroborates with the clinical findings and grades the valve as having a score of 11.

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