Abstract
A 45-year-old female was found to have a heart murmur during a routine check-up. Transthoracic echocardiogram showed normal chambers volumes and biventricular systolic function; there was mild tricuspid regurgitation with a transvalvular gradient of ±56 mmHg and an elevated gradient (±32 mmHg) was present in the suprasternal view (Figure 1A).
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