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Image challenge
Murmur in a man with acute myocardial infarction
  1. Alejandro Ezquerra-Osorio,
  2. Miguel Angel Lopez-Lizarraga,
  3. Luis Augusto Baeza-Herrera
  1. Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico
  1. Correspondence to Dr Alejandro Ezquerra-Osorio, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico, Mexico; aeo900{at}yahoo.com.mx

http://dx.doi.org/10.1136/emermed-2023-213280

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    Clinical introduction

    A man in his 60s with history of smoking presented to the emergency room 10 days after an epigastric pain and progressive worsening dyspnoea. Vital signs were normal. Examination revealed bibasilar crackles and a murmur in the left sternal border. ECG shows an inferior wall myocardial infarction with Q-waves and T-wave inversion. The murmur and transthoracic echocardiography image are shown in figure-video 1.

    Video 1 Transthoracic echocardiographic image in parasternal short-axis view, electrocardiogram and phonocardiogram signals.

    Physical examination and echocardiographic findings are consistent with:

    1. acute mitral regurgitation

    2. left …

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    Footnotes

    • Twitter @dr_ezquerra

    • Contributors AEO wrote the manuscript and was involved in case management. MAL-L made figure and video. LAB-H made the echocardiogram and was involved in case management.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.