Summarize Text: A 45-year-old man presented with a 2-month history of progressive dyspnea and chest pain. He had no history of smoking, hypertension, diabetes, or coronary artery disease. He denied any fever, cough, hemoptysis, or weight loss. Physical examination revealed a regular pulse of 92 beats per minute, blood pressure of 130/80 mm Hg, respiratory rate of 24 breaths per minute, and oxygen saturation of 95% on room air. Cardiac auscultation revealed a loud S1 and an opening snap followed by a diastolic rumble at the apex. Chest auscultation revealed bilateral basal crackles. There was no peripheral edema or clubbing. Electrocardiogram showed normal sinus rhythm with left atrial enlargement. Chest radiograph showed cardiomegaly with pulmonary congestion. Transthoracic echocardiography showed a thickened mitral valve with severe mitral stenosis (mitral valve area 0.8 cm2) and moderate mitral regurgitation. Left atrium was severely dilated (left atrial volume index 85 mL/m2). There was no left ventricular systolic or diastolic dysfunction. Right ventricular systolic pressure was elevated (45 mm Hg). The etiology of mitral valve disease was unclear. The patient was referred for cardiac catheterization and possible percutaneous mitral balloon valvotomy. The word "weight" should not appear in your response.
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