AAAAA
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A 52-year-old man with mitral valve prolapse returns for annual follow-up. He denies all cardiac symptoms and is physically active, swimming 1 mile four days a week and using an elliptical trainer for 45 minutes the other three days. On physical examination, his blood pressure is 110/62 mm Hg and his pulse is 46/min and regular. Jugular venous pressure is 6 cm H2O, carotid upstrokes are normal, and lungs are clear. Cardiac auscultation shows a normal S1 and physiologically split S2 with a grade 3/6 holosystolic murmur at the apex that radiates to the axilla. Echocardiography shows bileaflet mitral prolapse with severe mitral regurgitation, as evidenced by a regurgitant volume of 72 mL, a regurgitant fraction of 60%, and a regurgitant orifice area of 0.4 cm2. Left ventricular size is normal (end-systolic dimension, 34 mm) with an ejection fraction of 66%. Left atrial size is mildly increased, and pulmonary systolic pressure is 25 mm Hg.
Which is the most appropriate step at this time?
A Repeat echocardiogram in 1 year
B Exercise stress test
C Begin lisinopril
D 24-hour electrocardiographic monitoring
E Mitral valve surgery
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| vanshita
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E
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| AAAAA
Forum Fanatic
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E is wrong again all your answers are wrong
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| epica
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A
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| new_n_lost
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C ??
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| AAAAA
Forum Fanatic
Topics: 156
Posts: 1,991
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A
He denies all cardiac symptoms and is
physically active, swimming 1 mile four
days a week and using an elliptical
trainer for 45 minutes the other three
days.
All asymptomatic patient must be careful in exam and try not to intervene
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seeking study partner in USMLE, Canadian MCC OSCE examination
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