Abstract
A 75-year-old woman presented with a two-month history of progressive dyspnea on exertion. On physical examination, her blood pressure was 148/90 mmHg, jugular venous pressure was 10 cmH(2)O with a prominent V wave, right ventricular heave was present and she had a systolic murmur at the right upper sternal border that varied with inspiration. The patient had a pulsatile liver, mild ascites and systolic bruits over both kidneys, with the diastolic component on the left side.
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