Clinical History 102

Forty-nine year old woman with a history of rheumatic mitral valvular stenosis who underwent percutaneous mitral valve commissurotomy in the past. She now presents with increasing symptoms of shortness of breath, a resting tachycardia and moderately severe mitral insufficiency. Medications at the time of this electrocardiogram included verapamil, digoxin, propafenone and aspirin.
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