5th May 2025

A 54-year-old woman presents with shortness of breath on exertion, fatigue, and palpitations.

A 54-year-old woman presents with shortness of breath on exertion, fatigue, and palpitations. On examination, her jugular venous pressure is elevated, and a pansystolic, high-pitched “whistling” murmur is heard. The murmur radiates to the left axilla. Her ECG shows AF with a ventricular rate of 140 bpm. What is the most likely structural cardiac abnormality that would cause her symptoms?

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