A 72-year-old male comes to the office with intermittent symptoms
of dyspnea on exertion, palpitations, and cough occasionally productive of
blood. On cardiac auscultation, a low-pitched diastolic rumbling murmur
is faintly heard toward the apex. The origin of the patient’s problem proba-
bly relates to
a. Rheumatic fever as a youth
b. Long-standing hypertension
c. Silent MI within the past year
d. Congenital origin
