Several Months Of Progressive in Medicine / Internal Medicine — 44yo Man | Cardiology | SMLE Q#16856

SMLE Question #16856

Medicine / Internal Medicine Cardiology

Objective: OBJ-163

Last updated: February 2026
A 44-year-old man presents with several months of progressive dyspnea on exertion. He denies chest pain, syncope, fever, or recent respiratory infection. Examination shows clear lung fields and no peripheral oedema. Cardiac auscultation reveals a high-pitched, blowing, early diastolic decrescendo murmur best heard at the left upper sternal border. The murmur becomes louder and longer with inspiration. Which of the following is the most likely cause of this murmur?

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