A 2/6 pansystolic murmur was heard on the mitral area
and a 2/4 early diastolic murmur was heard in the intercostal space.
Her physical examination revealed a grade 4/6 pan-systolic murmur in the mitral area
. Trans-thoracic and trans-esophageal echocardiogram revealed severe mitral regurgitation due to prolapse of the anterior mitral valve leaflet (AMVL), and a posteriorly directed regurgitant jet into the severely dilated left atrium was noted.
She was severely pale, afebrile, pulse rate 110/minute, respiratory rate 20/minute, blood pressure 90/60mm of Hg, Sp[O.sub.2] 96% at room air, prosthetic valve click at mitral area
and bilateral vesicular breath sounds present.
Prosthetic valve click was heard in the mitral area
with an ejection systolic murmur in pulmonary area indicating pulmonary hypertension.
On auscultation there was a loud S1 and a mid-diastolic murmur at mitral area
, pansystolic murmur was heard at tricuspid area, an ejection systolic murmur in pulmonary area (flow murmur) with wide and fixed split S2.