A 24-year-old man, who had a history of exertional dyspnea (functional class I), was referred to our clinic for cardiac evaluation. Physical examination revealed a holosystolic murmur (grade I/VI) in the mitral area and lower left sternal border. Echocardiography demonstrated normal left and right ventricular sizes and systolic functions. There was mild tricuspid regurgitation, and the systolic pulmonary arterial pressure was about 25 mmHg.
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