Valvular Heart Disease USMLE Step 1 Practice Question
A 28-year-old woman with a history of acute rheumatic fever now presents with a new diastolic murmur at the apex, dyspnea at rest, and orthopnea. Echocardiography shows a thickened, immobile mitral valve with a characteristic 'hockey stick' appearance in systole. Which of the following pathologic mechanisms best explains her symptoms?
Answer choices
- AImpaired left ventricular systolic function
- BMitral valve prolapse with leaflet eversion
- CEndocardial fibroelastosis of the left ventricle
- DAortic valve calcification and fibrosis
- ERestricted mitral valve opening causing elevated left atrial pressureCorrect answer
- FMyxomatous degeneration of mitral leaflets with excess proteoglycan accumulation
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