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Browse all exams A 68-year-old man presents with a 3 month history of progressive shortness of breath on exertion and ankle swelling. Previous history includes hypertension managed with ACE inhibitors. On examination, there is bilateral pitting edema in his lower extremities and a significant systolic murmur at his left sternal border. An echocardiogram shows left ventricular hypertrophy and a dilated left atrium. What is the likely pathophysiological mechanism?
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