Heart Failure USMLE Step 1 Practice Question
A 70-year-old man presents with hypotension four days following an anterior myocardial infarction. Vital signs show BP 85/52 mmHg, HR 118/min, RR 22/min, temperature 37.2°C, and SpO2 94% on room air. Physical examination reveals a new harsh holosystolic murmur best heard at the left lower sternal border. Troponin I remains elevated at 8.2 ng/mL. Chest X-ray shows mild pulmonary edema without significant cardiomegaly. He denies chest pain. Which diagnosis best explains these findings?
Answer choices
- APapillary muscle rupture
- BFree wall rupture
- CVentricular septal ruptureCorrect answer
- DVentricular aneurysm
- EDressler syndrome
- FAcute mitral regurgitation from papillary muscle dysfunction
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