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Week 7

 

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Quiz 7 Context:

A 39-year-old woman presents with the complaint of dyspnea on exertion and paroxysmal nocturnal dyspnea. The onset of symptoms began insidiously about 1 year ago. The symptoms seem to have worsened over the past several weeks. She describes a chronic cough with occasional blood-streaked sputum. She denies chest pain, fever, weight loss or other symptoms.

The patient's medical history is significant for childhood rheumatic fever. She does not consume alcohol, nicotine or illicit drugs.

The physical exam reveals a heart rate of 95 bpm, blood pressure of 128/80 mmHg, respiratory rate of 22/minute. The cardiac exam reveals an accentuated S-1, an accentuated P-2, an opening snap, and a low-pitched, mid-late diastolic rumbling murmur best heard at the left sternal border and apex. An EKG is obtained.

The EKG is shown above.

This is most consistent with which of the following?

  1. Left Ventricular Hypertrophy
  2. Right Ventricular Hypertrophy
  3. Wolff-Parkinson White Syndrome
  4. Acute Myocardial Infarction
  5. Pericarditis

 

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Center for Continuing Education | 9500 Euclid Avenue, KK31, Cleveland, OH 44195