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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.

Select Relevant Investigations
Echocardiography

Performed

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%.
Chest X ray

Performed

The chest x-ray is significant for cardiomegaly.
ECG

Performed

The ECG is positive for atrial fibrillation and a left bundle-branch block.
Coronary angiography

Performed

The Coronary Angiogram is normal.

Select Relevant Management
Endocarditis Prophylaxis
Anticoagulation
Mitral Valve replacement
Diuretics