Picture of the day - An elderly lady with shortness of breath


A 62 years old lady presented with a history of shortness of breath for 2 years. She denied cough or wheezing. There was no history of ischemic chest pain in the past. Family history was unremarkable.

On examination she was tachycardic. Blood pressure was 110/80mmHg. The house officer could not detect a murmur. Lungs were clear.


In view of the cardiomegaly on the Xray, the house officer started IV frusemide and aspirin.

The next day during the ward round, the consultant asked the HO to re-auscultate the patient.

What is the diagnosis?

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