ABSTRACT
Chest auscultation: bilateral inspiratory crackles at both lung bases. No peripheral oedema.
Investigations FBC: Hb 13.9, WCC 8.1, platelets 233. U&E: Na 137, K 4.2, urea 5.3, creatinine 88. Thyroid function: normal. Troponin I: negative. Chest X-ray: mild cardiomegaly, early pulmonary congestion. Echocardiogram: Anterior mitral valve leaflet prolapse with posteriorly directed jet of moderate mitral regurgitation into a moderately dilated left atrium. Left ventricular function mildly impaired (ejection fraction 47 per cent).
