AAAAA
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A 47-year-old woman with idiopathic cardiomyopathy presents for routine follow-up. She has dyspnea on exertion and fatigue with minimal activity. Her medications include enalapril, carvedilol, spironolactone, digoxin, and furosemide.
On examination, blood pressure is 95/70 mm Hg, heart rate is 65/min, the jugular venous pressure is normal, her chest is clear to auscultation, cardiac rhythm is regular with a grade 2/6 systolic murmur, and trace peripheral edema is present. A recent echocardiogram showed marked left ventricular enlargement, moderate mitral regurgitation, and severely decreased systolic function (left ventricular ejection fraction, 20%). Her laboratory results include hemoglobin, 11 g/dL (110 g/L), and creatinine, 1.2 mg/dL (106.1 μmol/L). An electrocardiogram is obtained and is shown (;" name=tip tip="[img>'../figures/thumbs/mk14_a_cv_mcq_f022.jpg'/[/img]] Figure 22).
Which of the following would most likely improve this patient's symptoms?
A Amlodipine B Outpatient dobutamine infusions C Mitral valve repair D Erythropoietin injections E Biventricular pacemaker
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| arlete
Intern in 2009!!!!!
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E
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| PGI2alpha
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i ll go fr C...as the EF is down to 20%...
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