TY - JOUR T1 - A 68-year-old man with acute exertional dyspnoea and holosystolic murmur JF - Emergency Medicine Journal JO - Emerg Med J SP - e2 LP - e2 DO - 10.1136/emermed-2020-211060 VL - 39 IS - 5 AU - Kosuke Ishizuka AU - Kiyoshi Shikino AU - Masatomi Ikusaka Y1 - 2022/05/01 UR - http://emj.bmj.com/content/39/5/e2.abstract N2 - A 68-year-old man presented to the ED with dizziness, nausea and cold sweats. Three days before presentation, he developed pink foamy sputum and exertional dyspnoea. On physical examination, the patient had a Levine III/VI holosystolic murmur, with the strongest point at the left sternal border of the third intercostal space. His N-terminal pro-brain natriuretic peptide (NT-proBNP) (5970 pg/mL) and troponin T (0.733 ng/mL) were elevated. Electrocardiography revealed ST elevation, abnormal Q wave, and coronary T wave in II, III and augmented Vector Foot (aVF). Echocardiography was performed (figure 1 and online supplemental video 1).Supplementary video [emermed-2020-211060supp001.mp4] Figure 1 Echocardiography: apical two-chamber view.Which of the following statements about the disease is false?The disease is a serious mechanical complication that occurs after … ER -