A 55-year-old hypeensive patient has a standing BP 190/100 and sitting BP-180/100. He also has irregularly irregular rhythm, double apical impulse, and bilateral basal crepitations. But no murmurs could be auscultated and hea rate could not be determined. What is the likely cause?

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Vikas Bhardwaj
Medical Technologist, AIIMS New Delhi
Updated: Apr 17, 2026