Valvular Heart Disease USMLE Step 1 Practice Question
A 58 year old woman presents with progressive fatigue and dyspnea on exertion. She has a history of remote rheumatic fever. Cardiac examination shows a blowing holosystolic murmur best heard at the apex with radiation to the axilla. Echocardiography shows left atrial dilation and eccentric left ventricular hypertrophy. Which of the following best explains the ventricular remodeling seen in this patient?
Answer choices
- ARight ventricular pressure overload from pulmonary stenosis
- BVolume overload during ventricular systoleCorrect answer
- CDecreased coronary perfusion during diastole only
- DPressure overload from fixed outflow obstruction
- ESevere reduction in preload from impaired venous return
- FIncreased afterload from systemic hypertension causing concentric remodeling
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