Occasional Palpitations in Medicine / Internal Medicine — 44yo Man | Cardiology | SMLE Q#11434
SMLE Question #11434
Medicine / Internal Medicine
Cardiology
Objective: OBJ-163
Last updated: February 2026
A 44-year-old man has progressive dyspnea on exertion for 6 months with occasional palpitations. He denies chest pain, syncope, or a history of rheumatic fever. Cardiac auscultation reveals a high-pitched, blowing, decrescendo diastolic murmur best heard at the left sternal border in the 3rd intercostal space with the patient leaning forward at end-expiration. Which valvular lesion most likely explains this murmur?
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