A 50 year old lady comes to your OPD. What is the most probable diagnosis ?

The above image shows Mitral facies which are seen in Mitral stenosis. Mitral stenosis may present with rosy cheeks, whilst the rest of the face has a bluish tinge due to cyanosis. In severe Mitral stenosis low cardiac output state produces vasoconstriction, peripheral cyanosis is often seen in lips, tip of nose and cheeks. Occasionally along with these, malar flush is seen due to vasodilation (vascular stasis) in malar area.