Valvular Heart Disease USMLE Step 1 Practice Question
A 52-year-old woman with hypertension and atrial fibrillation presents with dyspnea and fatigue. Cardiac examination reveals an irregularly irregular rhythm and a holosystolic murmur at the apex radiating to the axilla. Echocardiography shows a dilated left ventricle with markedly reduced ejection fraction and secondary mitral regurgitation. Which of the following best describes the etiology of her mitral regurgitation?
Answer choices
- APapillary muscle rupture from myocardial infarction
- BPrimary mitral valve leaflet pathology with structural damage
- CRheumatic mitral valve fusion and thickening
- DInfective endocarditis with vegetation on the valve
- EGeometric annular dilation and leaflet tethering from LV enlargementCorrect answer
- FChordae tendineae rupture from degenerative collagen disease
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.