Review Question - QID 214214

A 52-year-old-man presents to his primary care physician with 2 months of progressive fatigue and exercise intolerance. Two months ago, he was walking 3 miles a day. Currently, he is unable to walk more than 3 blocks without becoming short of breath. Along with these symptoms, he has been experiencing 2 weeks of intermittent palpitations and orthopnea. Patient records include documentation of a systolic heart murmur with a mid-systolic click by a physician many years ago. He has no other medical history and does not take any medications. He does not drink alcohol or smoke. His cardiovascular exam is notable for a holosystolic murmur best heard at the apex with radiation to the axilla. Which of the following findings would most likely be seen on echocardiography?