1st April 2022

You are a FY2 working in the Emergency Department. An 82-year-old lady is brought in by ambulance after collapsing

You are a FY2 working in the Emergency Department. An 82-year-old lady is brought in by ambulance after collapsing while gardening. She was unconscious for a matter of seconds. She tells you that she has been experiencing some fatigue and shortness of breath over the last few months. An ECG shows borderline large-amplitude QRS complexes in the anterior and lateral leads. On clinical examination, she has an absent second heart sound. You also note bilateral pitting oedema to the level of the mid-shin and bi-basal lung crepitations.  What is the most likely underlying pathology?

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