Q183. A 45-year-old female presented with a 6-month history of paroxysmal nocturnal dyspnea, palpitations, and breathlessness. JVP elevated, pulse irregularly irregular, tender hepatomegaly. A heaving apex was noted, and a mid-diastolic murmur (MDM) was heard at the apex. The patient also has a history of acute rheumatic fever. Which statement is TRUE?