Not for the faint-hearted

David, a 62-year-old man, was found unconscious about 100m from the main entrance of a hospital ED.

emergency

After regaining consciousness, he reported having felt dizzy and light-headed all day before eventually deciding to walk to the nearby hospital to be assessed.

He denied any other symptoms or past medical history and was not on any prescription medication.

On cardiovascular examination, his heart rate was irregularly irregular at 60-70bpm with a blood pressure of 90/70mmHg.

There was a loud, late-peaking ejection systolic murmur audible

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