Valvular Heart Disease USMLE Step 1 Practice Question
A 34-year-old male with a history of intravenous drug use presents to the emergency department with a 2-week history of fever, night sweats, and progressive dyspnea. On examination, temperature is 38.9°C, heart rate is 112 bpm, and respiratory rate is 22/min. Cardiac auscultation reveals a holosystolic murmur best heard at the left lower sternal border that increases in intensity with inspiration. Laboratory studies show a positive blood culture for methicillin-sensitive Staphylococcus aureus. Transthoracic echocardiography demonstrates a large, mobile vegetation adherent to the tricuspid valve with severe tricuspid regurgitation. Which of the following best explains the cardiac findings in this patient?
Answer choices
- AMitral regurgitation from endocarditis with septic embolization to the coronary arteries
- BAcute aortic regurgitation secondary to septic aortic root abscess
- CTricuspid regurgitation from infective endocarditis with vegetative destruction of valve leafletsCorrect answer
- DPulmonary regurgitation from acute pulmonary hypertension secondary to recurrent septic pulmonary emboli
- EFunctional tricuspid regurgitation from right ventricular dilation due to acute cor pulmonale
- FAcute right ventricular outflow tract obstruction from in situ thrombosis
See the full explanation
Get the correct-answer rationale, why each distractor is wrong, the underlying mechanism, and high-yield associations — plus adaptive practice that targets your weak areas — with a free MedBoardPRO account.