{"ops":[{"insert":"A 70 year old man presents with exertional dyspnea and palpitations for 2 months.\n\nHe 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.\n\nHis medical history is otherwise unremarkable.\n"},{"insert":"\n"},{"insert":{"image":"\/storage\/case-images\/pd\/PD-M-219_en.png"}},{"insert":"\n"}]}
2
Investigate
Echocardiography
{"ops":[{"insert":"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%.\n"}]}
Chest X ray
{"ops":[{"insert":"The chest x-ray is significant for cardiomegaly.\n"}]}
