A 70 year old man presents with exertional dyspnea and palpitations for 2 months. He was diagnosed with mitral valve prolapse at the age of 35 years, for which no interventions were performed. He defaulted on followup many years ago. His medical history is otherwise unremarkable.
There is moderate mitral regurgitation, while the mitral valve is moderately myxomatous and shows holosystolic prolapse. The left ventricle is dilated, although left ventricular function is good, with an ejection fraction of 56%.
The chest x-ray is significant for cardiomegaly.
The ECG is positive for atrial fibrillation and a left bundle-branch block.
The Coronary Angiogram is normal.