Valvular Heart Disease USMLE Step 1 Practice Question
A 48-year-old man with history of inferior myocardial infarction three days ago presents with acute dyspnea and orthopnea. Vital signs show BP 98/62, HR 118, RR 22, SpO2 89% on room air. Bilateral rales are appreciated on lung auscultation. A new holosystolic apical murmur increases with handgrip maneuver. Chest radiography demonstrates pulmonary edema. Transthoracic echocardiography reveals papillary muscle rupture with normal aortic valve. Which of the following is the most likely diagnosis?
Answer choices
- AAcute mitral regurgitation from papillary muscle ruptureCorrect answer
- BMitral stenosis from valve inflammation
- CAortic regurgitation from aortic root dissection
- DVentricular septal defect from septal rupture
- ETricuspid regurgitation from right ventricular infarction
- FAcute aortic stenosis from left ventricular outflow tract obstruction
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