What in the heart can Kill?


25 year old gentleman, presented with acute onset severe breathlessness with a background history of bilateral pedal edema for 20 days , mild breathing difficulty for 1week and 10kg weight loss in past two months. O/E he was hypertensive (200/80) ,afebrile, with bilateral diffuse crepitations.He also had a loud EDM in the secondary aortic area and loud P2 with Apex beat located at the anterior axillary line in the sixth intercostal space and no peripheral signs of Infective endocarditis.

What are the differentials?

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Department of Medicine, Christian Medical College, Vellore, Tamil Nadu, India

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