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This middle-aged man with no cardiac history but with significant history of methamphetamin and alcohol use presented with chestpain and SOB, worsening over days, with orthopnea. Mild to moderate mitral regurgitation. BP:143/99, Pulse 109, Temp 37.2 °C C (99 °F), Resp (!) No left ventricular wall motion abnormality identified.
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