Valvular Heart Disease USMLE Step 1 Practice Question
A 48 year old man presents with palpitations and awareness of a forceful heartbeat. He recently recovered from infective endocarditis. Blood pressure is 162/54 mm Hg. Examination shows head bobbing, bounding peripheral pulses, and a high pitched early diastolic decrescendo murmur heard best along the left sternal border when leaning forward in held expiration. Which of the following best explains this patient's widened pulse pressure?
Answer choices
- AReduced diastolic arterial pressure due to backflow into the left ventricleCorrect answer
- BDelayed closure of the pulmonic valve
- CImpaired right ventricular filling during diastole
- DLeft to right shunting across the atrial septum
- EFixed obstruction to left ventricular outflow during systole
- FDecreased systolic blood pressure from reduced forward stroke volume
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