Review Question - QID 214497

A 45-year-old man presents to his primary care physician for a general checkup. He states that he is generally healthy but has been more short of breath lately with exertion. He attributes it to his sedentary lifestyle and has been trying to go on more walks lately. The patient is generally healthy; however, he states that he has not seen a primary care doctor in over 10 years. Physical exam is notable for a diastolic murmur heard best at the right upper sternal border that radiates to the cardiac apex. The murmur is accentuated by the patient leaning forward while holding his breath in full expiration. Which of the following is associated with this diagnosis?