A 66-year-old lady was incidentally found to have a grade 3/6 pan-systolic murmur over the apex and radiating to the left axilla. She had no palpitation or heart failure symptoms. Her exercise tolerance was satisfactory and she could manage her daily housework without any difficulties. Resting ECG showed sinus rhythm and left ventricular hypertrophy. Chest radiograph showed mild cardiomegaly. An echocardiogram was performed (Figure).