Occasional Palpitations in Medicine / Internal Medicine — 44yo Man | Cardiology | SMLE Q#11862

SMLE Question #11862

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 44-year-old man has progressive dyspnea on exertion for several months with occasional palpitations. He denies chest pain, syncope, or peripheral edema. Cardiac auscultation reveals a high-pitched, blowing, early diastolic decrescendo murmur best heard at the left upper sternal border that becomes louder with deep inspiration. Which of the following is the most likely cause of this murmur?

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