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Abstract

A 60-year-old male patient with type 2 diabetes mellitus (DM)and hypertension presented to cardiology department (January2018) with exertional dyspnea [New York Heart Association(NYHA) class II] since last two months. General examinationrevealed pulsus parvus et tardus along with systolic blood pressure(SBP) of 90 mmHg in right hand supine position. Cardiovascu-lar examination revealed heaving apex, grade IV/VI late peakingsystolic murmur at aortic area with decreased intensity of aor-tic closure sound. Previously, in 2010 also he had presented withNYHA class II dyspnea and exertional giddiness.

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