Corresponding author: Antonio Grimaldi, MD Department of Cardiothoracic and Vascular Surgery Università Vita-Salute San Raffaele Via Olgettina 60 20132 Milan, Italy e.mail: [email protected] A 75-year-old man with acute worsening of heart failure symptoms and a clinical history of prior rheumatic fever, presented with blood pressure 150/60 mmHg and a high-pitched diastolic murmur in the a...