Valvular Heart Disease USMLE Step 1 Practice Question
A 68-year-old man with a history of myocardial infarction 2 weeks ago presents with acute dyspnea, hypotension, and a new holosystolic murmur at the left lower sternal border. Pulmonary edema is evident on chest X-ray. Echocardiography shows a ventricular septal defect with left-to-right shunting. Which of the following complications explains his acute presentation?
Answer choices
- ADevelopment of left ventricular free wall rupture
- BRupture of the ventricular septum from infarction and necrosisCorrect answer
- CSpontaneous closure of the VSD
- DMechanical mitral regurgitation from papillary muscle dysfunction
- EIschemic mitral stenosis from annular dilation
- FAcute mitral regurgitation from papillary muscle rupture
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