A 72-year-old widow of Greek origin, and with limited English skills, is brought to you by her family who are concerned about her health. She insists that apart from mild shortness of breath she is quite well. On physical examination she is moderately obese. The other positive findings include a grade 2 systolic ejection murmur in the second right intercostal space radiating into the neck. Her BP is 190/95 and the only other finding is obvious osteoarthritis of both knees. An ECG was done.

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