Sitting Up in Medicine / Internal Medicine — 45yo Man | Cardiology | SMLE Q#341

SMLE Question #341

Medicine / Internal Medicine Cardiology
Last updated: February 2026
A 45-year-old man is referred after a murmur was noted during a routine examination. He denies chest pain, dyspnoea, palpitations, or syncope. Cardiac auscultation reveals a high-pitched, blowing early diastolic decrescendo murmur best heard at the left sternal border with the patient sitting up, leaning forward, and at end-expiration. Which valvular lesion is most consistent with this finding?

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